Strain Echocardiography and Wall Motion Score Index Predicts Final Infarct Size in Patients With Non–ST-Segment–Elevation Myocardial Infarction
- 1 March 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Cardiovascular Imaging
- Vol. 3 (2), 187-194
- https://doi.org/10.1161/circimaging.109.910521
Abstract
Background— Infarct size is a strong predictor of mortality and major adverse cardiovascular events after myocardial infarction. Acute reperfusion therapy limits infarct size and improves survival, but its use has been confined to patients with ST-segment–elevation myocardial infarction. The purpose of this study was to assess the relationship between echocardiographic parameters of left ventricular (LV) systolic function obtained before revascularization and final infarct size in patients with non–ST-segment–elevation myocardial infarction, as well as the ability of these parameters to identify patients with substantial infarction. Methods and Results— Sixty-one patients with non–ST-segment–elevation myocardial infarction were examined by echocardiography immediately before revascularization, 2.1�0.6 days after hospitalization. LV systolic function was assessed by ejection fraction, wall motion score index, and circumferential, longitudinal, and radial strain in a 16-segment LV model. Global strain represents average segmental strain values. Infarct size was assessed after 9�3 months by late-enhancement MRI, as a percentage of total LV myocardial volume. A good correlation was found between infarct size and wall motion score index ( r =0.74, P r =0.68, P −13.8% and wall motion score index >1.30 accurately identified patients with substantial infarction (≥12% of myocardium, n=13; area under the receiver operator curve, 0.95 and 0.92, respectively). Conclusions— Echocardiographic parameters of LV systolic function correlate to infarct size in patients with non–ST-segment–elevation myocardial infarction. Global longitudinal strain and wall motion score index are both excellent parameters to identify patients with substantial myocardial infarction, who may benefit from urgent reperfusion therapy.Keywords
This publication has 22 references indexed in Scilit:
- Prediction of All-Cause Mortality From Global Longitudinal Speckle StrainCirculation: Cardiovascular Imaging, 2009
- Diagnostic Capability and Reproducibility of Strain by Doppler and by Speckle Tracking in Patients With Acute Myocardial InfarctionJACC: Cardiovascular Imaging, 2009
- Noninvasive Separation of Large, Medium, and Small Myocardial Infarcts in Survivors of Reperfused ST-Elevation Myocardial InfarctionCirculation: Cardiovascular Imaging, 2008
- Global longitudinal strain measured by two-dimensional speckle tracking echocardiography is closely related to myocardial infarct size in chronic ischaemic heart diseaseClinical Science, 2007
- Early Prediction of Infarct Size by Strain Doppler Echocardiography After Coronary ReperfusionJournal of the American College of Cardiology, 2007
- Redefinition of Myocardial InfarctionCirculation, 2006
- Wall motion score index and ejection fraction for risk stratification after acute myocardial infarctionAmerican Heart Journal, 2006
- The quantification of infarct sizeJournal of the American College of Cardiology, 2004
- Myocardial salvage after coronary stenting plus abciximab versus fibrinolysis plus abciximab in patients with acute myocardial infarction: a randomised trialThe Lancet, 2002
- Estimates of myocardium at risk and collateral flow in acute myocardial infarction using electrocardiographic indexes with comparison to radionuclide and angiographic measuresJournal of the American College of Cardiology, 1995