Speckle tracking echocardiography is a sensitive tool for the detection of myocardial ischemia: a pilot study from the catheterization laboratory during percutaneous coronary intervention.
Analysis of rotational myocardial motion has been reported to be a sensitive index of myocardial ischemia. In this study, circumferential and radial myocardial strain and displacement was monitored during angioplasty balloon-induced myocardial ischemia in 8 patients undergoing percutaneous coronary intervention. The circumferential and radial variables were measured simultaneously in parasternal short-axis view at the papillary muscle level using the recently introduced speckle tracking echocardiography technique that allows 2-dimensional, angle-independent, real-time evaluation of the myocardial motion (2-dimensional strain modality). Acute regional myocardial ischemia caused a significant reduction of circumferential (-35.6 +/- 23.1%) and radial (-27.1 +/- 23.2%) strain and displacement (-49.6 +/- 27.2% and -43.2 +/- 26.8%, respectively). Simultaneously, time to the respective peak systolic values became significantly prolonged, the circumferential ischemic response in temporal domain being more pronounced (P < .05). Speckle tracking echocardiography-based analysis of rotational myocardial motion has a potential to become an efficient clinical bedside tool in the detection of acute ischemic regional myocardial dysfunction.
Winter
Reidar
R
Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. reidar.winter@karolinska.se <reidar.winter@karolinska.se>
Jussila
Risto
R
Nowak
Jacek
J
Brodin
Lars-Ake
LA
D000368:Aged; D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D002404:Catheterization; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity