title: Usefulness of Speckle-Tracking Imaging for Right Ventricular Assessment after Acute Myocardial Infarction: A Magnetic Resonance Imaging/Echocardiographic Comparison within the Relation between Aldosterone and Cardiac Remodeling after Myocardial Infarction Study.
abstract: BACKGROUND
  Right ventricular (RV) dysfunction after acute myocardial infarction (AMI) is frequent and associated with poor prognosis. The complex anatomy of the right ventricle makes its echocardiographic assessment challenging. Quantification of RV deformation by speckle-tracking echocardiography is a widely available and reproducible technique that readily provides an integrated analysis of all segments of the right ventricle. The aim of this study was to investigate the accuracy of conventional echocardiographic parameters and speckle-tracking echocardiographic strain parameters in assessing RV function after AMI, in comparison with cardiac magnetic resonance imaging (CMR).
  
  
  METHODS
  A total of 135 patients admitted for AMI (73 anterior, 62 inferior) were prospectively studied. Right ventricular function was assessed by echocardiography and CMR within 2 to 4 days of hospital admission. Right ventricular dysfunction was defined as CMR RV ejection fraction < 50%. Right ventricular global peak longitudinal systolic strain (GLPSS) was calculated by averaging the strain values of the septal, lateral, and inferior walls.
  
  
  RESULTS
  Right ventricular dysfunction was documented in 20 patients. Right ventricular GLPSS was the best echographic correlate of CMR RV ejection fraction (r = -0.459, P < .0001) and possessed good diagnostic value for RV dysfunction (area under the receiver operating characteristic curve [AUROC], 0.724; 95% CI, 0.590-0.857), which was comparable with that of RV fractional area change (AUROC, 0.756; 95% CI, 0.647-0.866). In patients with inferior myocardial infarctions, the AUROCs for RV GLPSS (0.822) and inferolateral strain (0.877) were greater than that observed for RV fractional area change (0.760) Other conventional echocardiographic parameters performed poorly (all AUROCs < 0.700).
  
  
  CONCLUSIONS
  After AMI, RV GLPSS is the best correlate of CMR RV ejection fraction. In patients with inferior AMIs, RV GLPSS displays even higher diagnostic value than conventional echocardiographic parameters.
authors.affiliation: Service de Réanimation Médicale, Hôpital Central, Centre Hospitalier Universitaire de Nancy, Nancy, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Lemarié
authors.affiliation: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huttin
authors.affiliation: Centre d'Investigations Cliniques - INSERM, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
authors.affiliation: Service de Médecine Nucléaire, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Mandry
authors.affiliation: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.affiliation: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Moulin
authors.affiliation: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Lemoine
authors.affiliation: Centre d'Investigations Cliniques - INSERM, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Beaumont
authors.affiliation: Service de Médecine Nucléaire, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marie
authors.affiliation: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France. Electronic address: c.suty-selton@chu-nancy.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Selton-Suty
mesh_terms: D000450:Aldosterone / Q000097:blood*; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012372:ROC Curve; D012189:Retrospective Studies; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D000450:Aldosterone
keywords: Coronary disease; Diagnosis; Echocardiography; Magnetic resonance imaging; Myocardial infarction