Longitudinal peak strain detects a smaller risk area than visual assessment of wall motion in acute myocardial infarction

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Rosendahl, Lene,1963-Linköpings universitet,Klinisk fysiologi,Hälsouniversitetet (author)

Longitudinal peak strain detects a smaller risk area than visual assessment of wall motion in acute myocardial infarction

Article/chapterEnglish2010

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2010-01-11
BioMed Central (BMC),2010
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LIBRIS-ID:oai:DiVA.org:hj-63325
https://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-63325URI
https://doi.org/10.1186/1476-7120-8-2DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-54292URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Original Publication: Lene Rosendahl, Peter Blomstrand, Lars Brudin, Tim Tödt and Jan E Engvall, Longitudinal peak strain detects a smaller risk area than visual assessment of wall motion in acute myocardial infarction, 2010, Cardiovascular ultrasound, (8), 2, 1-12. http://dx.doi.org/10.1186/1476-7120-8-2 Licensee: BioMed Central http://www.biomedcentral.com/
Background. Opening of an occluded infarct related artery reduces infarct size and improves survival in acute ST-elevation myocardial infarction (STEMI). In this study we performed tissue Doppler analysis (peak strain, displacement, mitral annular movement (MAM)) and compared with visual assessment for the study of the correlation of measurements of global, regional and segmental function with final infarct size and transmurality. In addition, myocardial risk area was determined and a prediction sought for the development of infarct transmurality 50%.Methods. Twenty six patients with STEMI submitted for primary percutaneous coronary intervention (PCI) were examined with echocardiography on the catheterization table. Four to eight weeks later repeat echocardiography was performed for reassessment of function and magnetic resonance imaging for the determination of final infarct size and transmurality.Results. On a global level, wall motion score index (WMSI), ejection fraction (EF), strain, and displacement all showed significant differences (p ≤ 0.001, p ≤ 0.001, p ≤ 0.001 and p = 0.03) between the two study visits, but MAM did not (p = 0.17). On all levels (global, regional and segmental) and both pre- and post PCI, WMSI showed a higher correlation with scar transmurality compared to strain. We found that both strain and WMSI predicted the development of scar transmurality 50%, but strain added no significant information to that obtained with WMSI in a logistic regression analysis.Conclusions. In patients with acute STEMI, WMSI, EF, strain, and displacement showed significant changes between the pre- and post PCI exam. In a ROC-analysis, strain had 64% sensitivity at 80% specificity and WMSI around 90% sensitivity at 80% specificity for the detection of scar with transmurality 50% at follow-up.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
gadolinium pentetate
acute heart infarction
adult
aged
apparatus
article
clinical article
diagnostic imaging
diagnostic value
echocardiography
female
heart ejection fraction
heart infarction size
heart ventricle wall motion
human
image analysis
image enhancement
male
measurement
nuclear magnetic resonance imaging
scar
scoring system
sensitivity and specificity
tissue Doppler imaging
wall motion score index
clinical trial
convalescence
Doppler echocardiography
echography
follow up
heart infarction
heart stroke volume
hospitalization
methodology
middle aged
observer variation
prediction and forecasting
receiver operating characteristic
reproducibility
risk factor
standard
statistics
transluminal coronary angioplasty
validation study
Angioplasty
Transluminal
Percutaneous Coronary
Echocardiography
Doppler
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Myocardial Infarction
Predictive Value of Tests
Recovery of Function
Reproducibility of Results
Risk Factors
ROC Curve
Severity of Illness Index
Stroke Volume
MEDICINE

Added entries (persons, corporate bodies, meetings, titles ...)

Blomstrand, PeterDepartment of Clinical Physiology, Ryhov County Hospital, Jönköping, Sweden(Swepub:liu)petbl44 (author)
Brudin, LarsLinköpings universitet,Klinisk fysiologi,Hälsouniversitetet(Swepub:liu)larbr27 (author)
Tödt, TimLinköpings universitet,Kardiologi,Hälsouniversitetet(Swepub:liu)timto81 (author)
Engvall, Jan EÖstergötlands Läns Landsting,Linköpings universitet,Klinisk fysiologi,Hälsouniversitetet,Fysiologiska kliniken(Swepub:liu)janen74 (author)
Linköpings universitetKlinisk fysiologi (creator_code:org_t)

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In:Cardiovascular Ultrasound: BioMed Central (BMC)8:11476-7120

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