title: Usefulness of ultrasonic strain measurements to predict regional wall motion recovery in patients with acute myocardial infarction after percutaneous coronary intervention.
abstract: Strain Doppler echocardiography can detect systolic regional myocardial dysfunction. This study assessed whether strain could predict recovery of regional left ventricular function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention. Forty-three patients with anterior AMI undergoing successful percutaneous coronary intervention of the left anterior descending coronary artery were studied. Longitudinal myocardial strain was measured at the left anterior descending coronary artery territory in the apical long-axis view within 24 hours after percutaneous coronary intervention. Regional wall motion was analyzed by the anterior wall motion score index (A-WMSI). Viable myocardium was defined as a decrease < or = 2.0 in A-WMSI. Patients were categorized as A-WMSI at 4 weeks into a viable group (n = 24) and a nonviable group (n = 19). End-systolic strain and peak strain were significantly lower in the nonviable group than in the viable group (-4.8 +/- 4.8% vs -9.9 +/- 4.7 %, p <0.005; -9.9 +/- 4.6 vs -13.5 +/- 4.1 %, p <0.05). Moreover, corrected time to peak strain (cTPS; time delay from end-systolic to peak strain/RR interval) was significantly longer in the nonviable group than in the viable group (0.19 +/- 0.04 vs 0.13 +/- 0.03, p <0.0001). For prediction of viable myocardium, cTPS <0.15 had a sensitivity of 95% and a specificity of 85%. In conclusion, strain, especially cTPS, is useful for predicting recovery of regional left ventricular function in patients with AMI after percutaneous coronary intervention.
authors.affiliation: Division of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan. yoshio@tokushima-med.jrc.or.jp
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ohara
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hosokawa
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Riyo
authors.initials: R
authors.lastname: Ogura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyajima
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yuba
authors.forename: Naoki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Takefumi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Kishi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohtani
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*