title: Detection of regional myocardial dysfunction in patients with acute myocardial infarction using velocity vector imaging.
abstract: OBJECTIVE
  Velocity vector imaging (VVI) is a new echocardiographic technique of measuring regional myocardial velocities and deformation. Our aim was to evaluate the feasibility and accuracy of VVI in defining regional functional abnormalities in patients with an acute myocardial infarction.
  
  
  METHODS
  Standard echocardiography and delayed enhancement (DE) magnetic resonance imaging were performed in 32 patients (29 men, mean age 61.2 +/- 8.1 years) within 36 hours of primary angioplasty. Twenty healthy volunteers (16 men, mean age 34.6 +/- 6.3 years) served as control subjects. Using VVI for offline analysis, segmental longitudinal deformation indices were measured. Infarcted, adjacent, and remote left ventricular segments were defined according to DE magnetic resonance imaging and coronary angiography. Infarct transmurality was also graded based on the DE extent within each segment on DE magnetic resonance imaging (0%-25%, 26%-50%, 51%-75%, and >76% of wall thickness).
  
  
  RESULTS
  As compared with remote segments, myocardial infarction segments had significantly lower longitudinal systolic strain (S) (-9.6% vs -14.6%, P < .0001), lower S rate (-0.75 vs -1.08 s(-1), P < .0001), and a higher postsystolic S index (21% vs 8.3%, P < .001). By receiver operating characteristic curve analysis, a myocardial peak systolic longitudinal S lower than -6.5% in at least one ventricular segment showed best predictive value (94%) for detecting an infarcted left ventricle. Peak systolic S and S rate were useful predictors of the presence of regional dysfunction, and for the localization and transmural extent of the infarct.
  
  
  CONCLUSIONS
  VVI is a promising new tool for studying myocardial motion and deformation with good feasibility in the clinical setting. The assessment of myocardial longitudinal systolic S and S rate with VVI can be used to identify the presence, location, and the transmural extent of myocardial infarction.
authors: Department of Cardiovascular Diseases, Catholic University Leuven, Leuven, Belgium.
authors: Ruxandra
authors: R
authors: Jurcut
authors: Christos J
authors: CJ
authors: Pappas
authors: Pier Giorgio
authors: PG
authors: Masci
authors: Lieven
authors: L
authors: Herbots
authors: Mariola
authors: M
authors: Szulik
authors: Jan
authors: J
authors: Bogaert
authors: Frans
authors: F
authors: Van de Werf
authors: Walter
authors: W
authors: Desmet
authors: Frank
authors: F
authors: Rademakers
authors: Jens-Uwe
authors: JU
authors: Voigt
authors: Jan
authors: J
authors: D'hooge
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*