Viability assessment with global left ventricular longitudinal strain predicts recovery of left ventricular function after acute myocardial infarction.
BACKGROUND
The extent of viable myocardial tissue is recognized as a major determinant of recovery of left ventricular (LV) function after myocardial infarction. In the current study, the role of global LV strain assessed with novel automated function imaging (AFI) to predict functional recovery after acute infarction was evaluated.


RESULTS
A total of 147 patients (mean age, 61+/-11 years) admitted for acute myocardial infarction were included. All patients underwent 2D echocardiography within 48 hours of admission. Significant relations were observed between baseline AFI global LV strain and peak level of troponin T (r=0.64), peak level of creatine phosphokinase (r=0.62), wall motion score index (r=0.52), and viability index assessed with single-photon emission computed tomography (r=0.79). At 1-year follow-up, LV ejection fraction was reassessed. Patients with absolute improvement in LV ejection fraction > or =5% at 1-year follow-up (n=70; 48%) had a higher (more negative) baseline AFI global LV strain (P<0.0001). Baseline AFI global LV strain was a predictor for change in LV ejection fraction at 1-year follow-up. A cutoff value for baseline AFI global LV strain of -13.7% yielded a sensitivity of 86% and a specificity of 74% to predict LV functional recovery at 1-year follow-up.


CONCLUSIONS
AFI global LV strain early after acute myocardial infarction reflects myocardial viability and predicts recovery of LV function at 1-year follow-up.
Mollema
Sjoerd A
SA
Department of Cardiology and the Department of Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
Delgado
Victoria
V
Bertini
Matteo
M
Antoni
M Louisa
ML
Boersma
Eric
E
Holman
Eduard R
ER
Stokkel
Marcel P M
MP
van der Wall
Ernst E
EE
Schalij
Martin J
MJ
Bax
Jeroen J
JJ
D000368:Aged; D001331:Automation; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D018618:Echocardiography, Doppler, Color; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D013997:Time Factors; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon; D020107:Troponin T / Q000097:blood; D016277:Ventricular Function, Left
D015415:Biomarkers; D020107:Troponin T; D003402:Creatine Kinase