Longitudinal Strain Is a Marker of Microvascular Obstruction and Infarct Size in Patients with Acute ST-Segment Elevation Myocardial Infarction

被引:29
作者
Biere, Loic [1 ,2 ]
Donal, Erwan [3 ,4 ,5 ]
Terrien, Gwenola [1 ,2 ]
Kervio, Gaelle [3 ,4 ,5 ]
Willoteaux, Serge [1 ,6 ]
Furber, Alain [1 ,2 ]
Prunier, Fabrice [1 ,2 ]
机构
[1] LUNAM Univ, Angers, France
[2] Univ Angers, CHU Angers, Lab Cardioprotect Remodelage & Thrombose, UPRES,EA3860,Serv Cardiol, Angers, France
[3] CHU Rennes, Serv Cardiol, Rennes, France
[4] CHU Rennes, CIC IT 804, Rennes, France
[5] INSERM, U1099, Lab Traitement Signal & Image, Rennes, France
[6] Univ Angers, CHU Angers, Lab Cardioprotect Remodelage & Thrombose, UPRES,EA3860,Serv Radiol, Angers, France
来源
PLOS ONE | 2014年 / 9卷 / 01期
关键词
SPECKLE TRACKING ECHOCARDIOGRAPHY; LEFT-VENTRICULAR FUNCTION; WALL-MOTION SCORE; 2-DIMENSIONAL STRAIN; CLINICAL-IMPLICATIONS; EJECTION FRACTION; QUANTIFICATION; REPERFUSION; VALIDATION; ANGIOPLASTY;
D O I
10.1371/journal.pone.0086959
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objectives: We assessed the value of speckle tracking imaging performed early after a first ST-segment elevation myocardial infarction (STEMI) in order to predict infarct size and functional recovery at 3-month follow-up. Methods: 44 patients with STEMI who underwent revascularization within 12 h of symptom onset were prospectively enrolled. Echocardiography was performed 3.9 +/- 1.2 days after myocardial reperfusion, assessing circumferential (CGS), radial (RGS), and longitudinal global (GLS) strains. Late gadolinium-enhanced cardiac magnetic imaging (CMR), for assessing cardiac function, infarct size, and microvascular obstruction (MVO), was conducted 5.6 +/- 2.5 days and 99.4 +/- 4.6 days after myocardial reperfusion. Results: GLS was evaluable in 97% of the patients, while CGS and RGS could be assessed in 85%. Infarct size significantly correlated with GLS (R = 0.601, p < 0.001), RGS (R = -0.405, p = 0.010), CGS (R = 0.526, p = 0.001), ejection fraction (R = -0.699, p < 0.001), wall motion score index (WMSI) (R = 0.539, p = 0.001), and left atrial volume (R = 0.510, p < 0.001). Baseline ejection fraction and GLS were independent predictors of 3-month infarct size. MVO mass significantly correlated with GLS (R = 0.376, p = 0.010), WMSI (R = 0.387, p = 0.011), and ejection fraction (R = -0.389, p = 0.011). In multivariate analysis, GLS was the only independent predictor of MVO mass (p = 0.015). Longitudinal strain >-6.0% within the infarcted area exhibited 96% specificity and 61% sensitivity for predicting the persistence of akinesia (>= 3 segments) at 3-month follow-up. Conclusions: Speckle-tracking strain imaging performed early after a STEMI is easy-to-use as a marker for persistent akinetic territories at 3 months. In addition, GLS correlated significantly with MVO and final infarct size, both parameters being relevant post-MI prognostic factors, usually obtained via CMR.
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页数:9
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