Early Prediction of Infarct Size by Strain Doppler Echocardiography After Coronary Reperfusion
| Autor: | Helge Skulstad, Harald Brunvand, Thor Edvardsen, Thomas Helle-Valle, Halfdan Ihlen, Trond Vartdal, Eirik Pettersen, Erik Lyseggen, Hans-Jørgen Smith |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Duplex ultrasonography medicine.medical_treatment Myocardial Infarction Myocardial Reperfusion Doppler echocardiography Revascularization Risk Assessment Ventricular Function Left Reperfusion therapy Predictive Value of Tests Internal medicine medicine Humans Myocardial infarction Ejection fraction medicine.diagnostic_test business.industry Percutaneous coronary intervention Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Echocardiography Doppler Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 49:1715-1721 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2006.12.047 |
| Popis: | ObjectivesThe objective of this study was to investigate whether strain Doppler echocardiography performed immediately after revascularization by percutaneous coronary intervention could predict the extent of myocardial scar, determined by contrast-enhanced magnetic resonance imaging (MRI).BackgroundThere is considerable variability in survival rate after percutaneous coronary intervention, and accurate early risk stratification is therefore of major clinical importance.MethodsThirty individuals with acute anterior myocardial infarction were examined with longitudinal strain by Doppler 1.5 h after revascularization. The extent of scarring 9 months later was analyzed by MRI in 16 corresponding myocardial segments. Strain in all left ventricular segments was averaged to obtain a global value. Infarct size was estimated by clinical parameters and cardiac markers.ResultsA good correlation was found between the global strain and total infarct size (R = 0.77, p < 0.00001). A multivariate regression analysis showed that global peak strain and serum glutamic oxaloacetic transaminase correlated with the infarct size measured by MRI (p = 0.0001 and p = 0.001, respectively). Furthermore, a clear inverse relationship was found between the segmental strain and the transmural extent of infarction in each segment (R = 0.67, p < 0.0001).ConclusionsThis study demonstrates that assessment of regional and global strain at 1.5 h after reperfusion therapy correlates with size and transmural extent of myocardial infarction as determined by contrast-enhanced MRI. The novel global strain parameter is a valuable predictor of the total extent of myocardial infarction and may therefore be an important clinical tool for risk stratification in the acute phase of myocardial infarction. |
| Databáze: | OpenAIRE |
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