title: Global and regional left ventricular strain indices in post-myocardial infarction patients with ventricular arrhythmias and moderately abnormal ejection fraction.
abstract: The aim of the study described here was to compare myocardial strains in ischemic heart patients with and without sustained ventricular tachycardia (VT) and moderately abnormal left ventricular ejection fraction (LVEF) to investigate which index could better predict VT on the basis of the analysis of global and regional left ventricular (LV) dysfunction. We studied 467 patients with previous myocardial infarction and LVEF >35%. Fifty-one patients had documented VT, and 416 patients presented with no VT. LV volumes and score index were obtained by 2-D echocardiography. Longitudinal, radial and circumferential strains were determined. Strains of the infarct, border and remote zones were also obtained. There were no differences in standard LV 2-D parameters between patients with and those without VT. Receiver operating characteristic values were -12.7% for global longitudinal strain (area under the curve [AUC] = 0.72), -4.8% for posterior-inferior wall circumferential strain (AUC = 0.80), 61 ms for LV mechanical dispersion (AUC = 0.84), -10.1% for longitudinal strain of the border zone (AUC = 0.86) and -9.2% for circumferential strain of the border zone (AUC = 0.89). In patients with previous myocardial infarction and moderately abnormal LVEF, peri-infarct circumferential strain was the strongest predictor of documented ventricular arrhythmias among all strain quantitative indices. Additionally, strain values from posterior-inferior wall infarctions had a higher association with arrhythmic events compared with global strain.
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Bich Lien
authors.initials: BL
authors.lastname: Nguyen
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Capotosto
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Persi
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Attilio
authors.initials: A
authors.lastname: Placanica
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Asim
authors.initials: A
authors.lastname: Rafique
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Piccirillo
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Gaudio
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Eli S
authors.initials: ES
authors.lastname: Gang
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Siegel
authors.affiliation: Sapienza University, Rome, Italy. Electronic address: vitar@tiscali.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitarelli
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: Myocardial infarction; Speckle tracking echocardiography; Sudden cardiac death; Ventricular arrhythmias