Differentiation of pseudodyskinesis of inferior left ventricular wall from inferior myocardial infarction by assessment of regional myocardial strain using two-dimensional speckle tracking echocardiography
| Autor: | Nobusada Funabashi, Taro Imaeda, Rei Yajima, Chiharu Yamaguchi, Akiyo Takahashi, Akihisa Kataoka, Mariko Saito, Kwangho Lee, Maiko Takahashi, Issei Komuro |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Speckle tracking echocardiography Inferior Wall Myocardial Infarction Ventricular Dysfunction Left Young Adult Speckle pattern Internal medicine medicine Humans Aged Aged 80 and over Dyskinesias Ejection fraction business.industry Myocardium Inferior Myocardial Infarction Middle Aged Diaphragm (structural system) Echocardiography Myocardial strain Cardiology Female Cardiology and Cardiovascular Medicine business Radial stress Inferior left |
| Zdroj: | International Journal of Cardiology. 152:362-368 |
| ISSN: | 0167-5273 |
| Popis: | To differentiate pseudodyskinesis (PD) of the inferior left ventricular (LV) wall from inferior myocardial infarction (IMI) noninvasively, we performed focal site evaluation using two-dimensional speckle tracking transthoracic echocardiography (TTE).Speckle tracking TTE was carried out in 57 patients, with 19 subjects in each of three groups (Group A, suspected PD; Group B, LV IMI; and Group C, controls). Inferior wall PD was defined as follows: compression of the inferior LV wall by the diaphragm in the LV short axis view with a normal electrocardiogram and no evidence of previous ischemic events.Respective values in Groups A-C for LV ejection fraction (EF) were 63.6 ± 4.2%, 52.3 ± 7.6%, and 61.5 ± 3.8%, for inferior wall speckle tracking focal site evaluation peak radial strain of 30.0 ± 14.3%, 7.5 ± 7.1%, and 42.1 ± 22.9%, for peak circumferential strain of 23.1 ± 6.0%, 16.8 ± 8.4%, and 22.7 ± 7.1%, and for longitudinal strain in the mid-inferior wall of 18.4 ± 3.4%, 11.4 ± 4.0% and 15.8 ± 5.9%. LVEF values were significantly lower in Group B than Groups A and C (P0.001), as were those of radial, circumferential, and longitudinal strains (P0.05). In receiver-operating characteristic analysis the optimal cut-off values with corresponding sensitivities and specificities for differentiation of PD from IMI were19% with 84.2% and 94.7% for radial,15% with 89.4% and 52.6% for circumferential, and15% with 73.6% and 100% for longitudinal strain, respectively.Determination of regional strain from speckle tracking TTE, especially radial and longitudinal strains, can provide focal and quantitative noninvasive evaluation for distinguishing PD of the inferior wall from IMI. |
| Databáze: | OpenAIRE |
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