title: Two-dimensional speckle tracking echocardiography for the prediction of reversible myocardial dysfunction after acute myocardial infarction: comparison with magnetic resonance imaging.
abstract: BACKGROUND
  We aimed to determine the predictive value of longitudinal, circumferential, and radial strains by two-dimensional speckle tracking echocardiography (2DSTE) for improvement in cardiac function after acute myocardial infarction (AMI) compared with that of contrast-enhanced cardiac magnetic resonance imaging (ceMRI).
  
  
  METHODS
  In 35 patients with first-time AMI, myocardial viability was assessed to predict recovery of function at follow-up (7 ± 2 months), prospectively. For each left ventricular segment, each peak strains were determined using 2DSTE, and the relative extent of hyperenhancement was assessed using ceMRI.
  
  
  RESULTS
  Of 176 segments with impaired function early after AMI, 99 segments showed regional recovery. Compared with segments showing functional improvement, those that failed to recover had lower peak radial (20 ± 16% vs. 32 ± 21%; P < 0.001), circumferential (-10 ± 5% vs. -20 ± 6%; P < 0.001), and longitudinal (-10 ± 5% vs. -14 ± 5%; P < 0.001) strain and a greater extent of hyperenhancement (71 ± 22% vs. 27 ± 20%; P < 0.001). Among strain parameters, circumferential strain yielded greater area under the curve (AUC; 0.899) than radial and longitudinal strain (0.682 and 0.718, respectively). The predictive value of circumferential strain (sensitivity 81.0%, specificity 79.6%, at a cutoff value of -14.3%) could be comparable to that of hyperenhancement (sensitivity 86.2%, specificity 83.9%, AUC 0.921, at a cutoff value of 47%) (P = 0.439).
  
  
  CONCLUSIONS
  Circumferential strain can identify reversible myocardial dysfunction after AMI with a diagnostic ability comparable to that of ceMRI.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Orii
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hirata
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Shiono
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shimamura
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamano
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000208:Acute Disease; D000368:Aged; D019540:Area Under Curve; D003287:Contrast Media; D004452:Echocardiography / Q000379:methods; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009203:Myocardial Infarction / Q000150:complications*; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*
chemical_list: D003287:Contrast Media
keywords: cardiac magnetic resonance imaging; myocardial infarction; strain