title: Tissue Doppler strain-mapping in the assessment of the extent of chronic myocardial infarction: validation using magnetic resonance imaging.
abstract: OBJECTIVE
  The distribution of myocardial strain values can be visualized by colour-coded strain images. We examined for the first time if this strain-mapping function can be used to study the extent of prior myocardial infarction.
  
  
  RESULTS
  Echocardiography and cardiac magnetic resonance imaging with delayed contrast enhancement were performed in 26 patients with chronic myocardial infarction. Two-dimensional strain images of the left ventricle were obtained in all standard apical views. Myocardial segments (n = 416) were assigned a score ranging from one to four based on the strain-coded colour of the segment, with higher scores representing worse myocardial function. Strain-mapping scores and quantitative strain values averaged, respectively, 1.3 +/- 0.6 and -16.4 +/- 7.6% in segments without infarction, 1.7 +/- 1.0 and -15.0 +/- 8.6% in non-transmural infarctions, and 2.8 +/- 1.2 and -6.5 +/- 8.6% in transmural infarctions. Strain-mapping had a sensitivity of 60% and a specificity of 95% in detecting segments with transmural myocardial infarction. Corresponding values for echocardiographic wall motion analysis were 50 and 96%. Strain-mapping was possible in 80% of the segments and inter-observer agreement was substantial (kappa = 0.63).
  
  
  CONCLUSIONS
  Strain-mapping is a clinically applicable method for the assessment of regional myocardial function in post-myocardial infarction patients. Strain-mapping has reasonable feasibility and is more sensitive in detecting infarction damage than routine wall motion analysis.
authors.affiliation: Department of Medicine, Division of Cardiology, Cardiovascular Laboratory, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Minna M
authors.initials: MM
authors.lastname: Kylmälä
authors.forename: Margareta K
authors.initials: MK
authors.lastname: Antila
authors.forename: Sari M
authors.initials: SM
authors.lastname: Kivistö
authors.forename: Kirsi
authors.initials: K
authors.lastname: Lauerma
authors.forename: Paula H
authors.initials: PH
authors.lastname: Vesterinen
authors.forename: Helena A
authors.initials: HA
authors.lastname: Hänninen
authors.forename: Lauri
authors.initials: L
authors.lastname: Toivonen
authors.forename: Mika K
authors.initials: MK
authors.lastname: Laine
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors