title: Two-dimensional longitudinal strain for the assessment of the left ventricular systolic function as compared with conventional echocardiographic methods in patients with acute coronary syndromes.
abstract: BACKGROUND
  The evaluation of the left ventricular (LV) function is one of the most important elements of diagnosis in patients with cardiovascular (CV) diseases. A low LV ejection fraction (LVEF) is a strong and independent predictor of CV events. Traditionally, echocardiography characterises the LV systolic function by the estimation of LVEF with use of the Simpson method, supported by the wall motion score index (WMSI). Speckle tracking imaging is a new method of LV function imaging based on the estimation of longitudinal peak systolic strain (LPSS), by tracing of the automatically detected myocardial speckles.
  
  
  OBJECTIVE
  To evaluate the usefulness of global longitudinal peak systolic strain (GLPSS) and regional longitudinal peak systolic strain (r-LPSS) in LV systolic function assessment and to compare LPSS with conventional parameters such as LVEF, WMSI and regional wall motion score index (r-WMSI).
  
  
  METHODS
  The study was performed in a group of 44 patients with a clinical diagnosis of acute coronary syndrome (mean age 63.6 ± 12.2 years). The LVEF, WMSI, r-WMSI were estimated by echocardiography (VIVID 7 Dimension, GE Healthcare, USA). Moreover, LPSS (GLPSS and r-LPSS) with use of automated function imaging (AFI) were also estimated.
  
  
  RESULTS
  In the study group mean LVEF was 43.1 ± 12.7%, mean WMSI: 1.68 ± 0.52, and GLPSS: -13.8 ± 5.6%. A very strong linear correlation between the conventional and new parameters was observed - for GLPSS and LVEF: r = -0.86 (p < 0.00001), for GLPSS and WMSI: r = 0.88 (p < 0.00001). The results of the regional myocardial contractility assessment (r-LPSS and r-WMSI) were also in agreement, especially for LV anterior wall (r = 0.87, p < 0.00001).
  
  
  CONCLUSIONS
  These results suggest a considerable usefulness of LPSS - a new method of echocardiographical imaging - in the estimation of global and regional LV function in patients with acute coronary syndrome and its agreement with conventional parameters such as LVEF and WMSI.
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland. robert.ryczek@kardiolog.pl
authors.forename: Robert
authors.initials: R
authors.lastname: Ryczek
authors.forename: Paweł
authors.initials: P
authors.lastname: Krzesiński
authors.forename: Paweł
authors.initials: P
authors.lastname: Krzywicki
authors.forename: Paweł
authors.initials: P
authors.lastname: Smurzyński
authors.forename: Andrzej
authors.initials: A
authors.lastname: Cwetsch
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D016277:Ventricular Function, Left