title: Automated assessment of myocardial viability after acute myocardial infarction by global longitudinal peak strain on low-dose dobutamine stress echocardiography.
abstract: BACKGROUND
  Low-dose dobutamine stress echocardiography (DSE) assesses myocardial viability at the early stage of acute myocardial infarction (AMI), but its assessment is subjective and variable. Automated function image (AFI) determines global longitudinal peak strain (GLPS) based on tissue tracking technique. The ability of GLPS obtained by AFI during dobutamine stress to assess myocardial viability after AMI was investigated.
  
  
  RESULTS
  Low-dose DSE at day 3 in 23 consecutive patients with AMI was performed using Vivid 7 (GE Healthcare). Segmental longitudinal peak strain with AFI and obtained GLPS was analyzed. Wall motion score index (WMSI) by echocardiography 1 month later was determined. In 18 patients, left ventriculography was also performed at 3.2±1.5 months later to obtain left ventricular ejection fraction (LVEF) and regional wall motion (RWM, SD/chord). GLPS was improved during dobutamine infusion at 10 µg · kg(-1) · min(-1) (-12.9 ± 3.5% to -15.2 ± 3.6%, P=0.0004). GLPS during dobutamine stress showed good correlations with follow-up WMSI (R=0.47, P=0.02), with peak CK-MB (R = 0.52, P=0.01), with RWM (R = -0.48, P=0.04), and with LVEF (R = -0.54, P=0.02), whereas GLPS at baseline showed no correlations with them. Averaged segmental peak strain at baseline and during stress were correlated with follow-up WMSI (R = 0.50 and 0.43, respectively), but not with LVEF.
  
  
  CONCLUSIONS
  GLPS during dobutamine stress determined by AFI is a promising, objective index to assess myocardial viability on the early stage of AMI.
authors.affiliation: Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan. iwakura@mac.com
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Iwakura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Koyama
authors.forename: Motoo
authors.initials: M
authors.lastname: Date
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Higuchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Inoue
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Kimura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nagai
authors.forename: Michio
authors.initials: M
authors.lastname: Imai
authors.forename: Yuko
authors.initials: Y
authors.lastname: Toyoshima
authors.forename: Makito
authors.initials: M
authors.lastname: Ozawa
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ito
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibuya
authors.forename: Shigemiki
authors.initials: S
authors.lastname: Omiya
authors.forename: Takashi
authors.initials: T
authors.lastname: Takagi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Morisawa
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000368:Aged; D001331:Automation; D002470:Cell Survival; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D018570:Risk Assessment; D013318:Stroke Volume; D013997:Time Factors; D018487:Ventricular Dysfunction, Left