Evaluation of myocardial infarction size with three-dimensional speckle tracking echocardiography: a comparison with single photon emission computed tomography

Abstract

To assess whether global and regional myocardial strains from three-dimensional speckle tracking echocardiography (3D-STE) correlate with myocardial infarction size (MIS) detected by single photon emission computed tomography (SPECT). Fifty-seven patients with a history of ST-segment elevation myocardial infarction (MI) within 3-6 months were enrolled, alongside 24 healthy volunteers. Left ventricular (LV) global area strain, global longitudinal strain (GLS), global radial strain, global circumferential strain, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) were measured and compared with the corresponding SPECT-detected MISs. Patients were sub-grouped into massive MIS group (MIS ≥ 12%) and small MIS group (MIS < 12%). Myocardial strains of all the LV segments were compared with the corresponding MIS. Global myocardial strain parameters, LVEF and WMSI of the patients were significantly different from the control group (all P < 0.05) and correlated well with MISs, most significantly for GLS (r = 0.728, P < 0.01). Significant differences in myocardial strain parameters were found between the massive and small MIS groups (all P < 0.05). Receiver operating characteristic curve analysis indicated that GLS had a highest diagnostic value and when the cutoff was -13.8%, the area under the curve was 0.84, with the 70.6% sensitivity and 87.5% specificity. Significant differences of myocardial strain parameters were observed between segments with and without transmural MIs (P < 0.01). 3D-STE myocardial strain parameters evaluated LV global MIS, 3D GLS had the highest diagnostic value. It also preliminarily gauged the degree of ischemia and necrosis of regional myocardial segments.

Efficacy of an early home-based cardiac rehabilitation program for patients after acute myocardial infarction

“…[13,14] The potential superiority of 3D-STE over 2D-STE imaging has recently been verified using cardiac magnetic resonance as a reference, in which 3D strain parameters provided higher diagnostic accuracy in reflecting the dysfunctional myocardium in an AMI animal model. [15] Cardiac dysfunction is related to myocardial fiber injury in certain directions; meanwhile, the evaluation of cardiac systolic function is the mainstay of risk assessment and management of cardiac diseases.…”

“…GAS reflects the global function assessment of the endocardial myocardium. [22] Wang et al [14] demonstrated that 3D-GAS could gauge the value of myocardial infarction size, but its diagnostic value was not better than 3D-GLS.…”

Real-time three-dimensional speckle tracking echocardiography: technical aspects and clinical applications

“…The superiority of RT3D-STE is salient for regional strain values; in particular, area, longitudinal, and circumferential 3D strains correlate with global scar extent. [30][31][32] RT3D-STE may provide indirect means for the accurate determination of transmural involvement in infarct segments. 33,34 in this context, one of the major potentials for RT3D-STE's future is the possibility to widen knowledge into cardiac pathophysiology and disease process.…”

“…in another study, 51 impaired LV mechanics and functional capacity were found in uncontrolled and untreated hypertensive patients in comparison with controls and well-controlled hypertensives. 3D GLS, GCS, GRS, and GAS were significantly decreased in patients with untreated or inadequately Table 3 Clinical applications of real-time three-dimensional speckle tracking echocardiography Diseases Coronary artery disease Accurate assessment of Lv function and detection of early-stage Lv dysfunction, 31,37 wall motion abnormalities, 7,26,28,29 infarction size, [30][31][32][33][34] and myocardial viability 35…”

A bal kamra korszerű echokardiográfiás vizsgálata – az M-módtól a 3D speckle-tracking képalkotásig

“…Kleijn és mtsai igazolták, hogy a 3DSTE során számított AS kvantitatív módon jellemzi a vizuális becsléssel igazolt BK-i falmozgászavarok meglétét [43]. Mindamellett az is igazolást nyert, hogy bizonyos paraméterek (például GLS) diagnosztikus erővel bírhatnak a myocardialis infarctus által érintett terület nagyságának diagnosztikájában [44]. A módszertan nagy jövővel bír, azonban további klinikai vizsgálatok szükségesek a szá-mított paraméterek diagnosztikus és prognosztikus érté-kének tisztázására.…”