title: Influence of microvascular dysfunction on regional myocardial deformation post-acute myocardial infarction: insights from a novel angiographic index for assessing myocardial tissue-level reperfusion.
abstract: To investigate the impact of microvascular dysfunction assessed by angiography on myocardial deformation assessed by two-dimensional speckle-tracking echocardiography in ST-segment elevation myocardial infarction (STEMI). A total of 121 STEMI patients who received primary percutaneous coronary intervention were included. Thrombolysis in myocardial infarction, Myocardial Perfusion Frame Count (TMPFC), a novel angiographic method to assess myocardial perfusion, was used to evaluate microvascular dysfunction. Two-dimensional speckle-tracking echocardiography was performed at 3-7 days after reperfusion. The infarction related regional longitudinal (RLS) strains as well as circumferential (RCS) and radial (RRS) ones, along with global longitudinal, circumferential (GCS), and radial (GRS) strains were measured. Patients with microvascular dysfunction had decreased peak amplitude of RLS (p = 0.012), RCS (p < 0.001), RRS (p = 0.012) at the regional level and decreased peak amplitude of GCS (p = 0.005), GRS (p = 0.012) at the global level. The RCS to RLS and RCS to RRS ratios were significantly different between patients without than with microvascular dysfunction (1.28 ± 0.31 vs. 1.07 ± 0.47, p = 0.027 and 0.69 ± 0.33 vs. 0.56 ± 0.28, p = 0.047). Receiver operator characteristics curves identified a cutoff value of 94 frames for TMPFC to differentiate between normal and abnormal wall motion score index in the sub-acute phase of STEMI (AUC = 0.72; p < 0.001). In the sub-acute phase of STEMI, the presence of microvascular dysfunction in infarcted tissue relates to reduced global and regional myocardial deformation. RCS alterations were more significant than RLS and RRS between patients with than without microvascular dysfunction. TMPFC was useful to predict left ventricular systolic dysfunction in the sub-acute phase of STEMI.
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Ben
authors.initials: B
authors.lastname: He
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Song
authors.initials: S
authors.lastname: Ding
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Qiao
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Lincheng
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Ge
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Xuedong
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China. pujun310@hotmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Pu
mesh_terms: D000368:Aged; D019540:Area Under Curve; D017023:Coronary Angiography; D003326:Coronary Circulation; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009200:Myocardial Contraction; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015588:Observer Variation; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D013314:Stress, Mechanical; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Microvascular dysfunction; Myocardial function; ST-segment elevation myocardial infarction; TIMI Myocardial Perfusion Frame Count