Assessment of Left Ventricular Myocardial Viability by 3-Dimensional Speckle-Tracking Echocardiography in Patients With Myocardial Infarction.
OBJECTIVE
To determine whether 3-dimensional (3D) speckle-tracking echocardiography could provide a new way to assess myocardial viability in patients with myocardial infarction (MI).


METHODS
Forty-five patients with MI underwent routine echocardiography, 2-dimensional (2D) speckle-tracking echocardiography, and 3D speckle-tracking echocardiography. Radionuclide myocardial perfusion/metabolic imaging was used as a reference standard to define viable and nonviable myocardia.


RESULTS
Among 720 myocardial segments in 45 patients, 368 showed abnormal motion on routine echocardiography; 204 of 368 were categorized as viable on single-photon emission computed tomography/positron emission tomography (SPECT/PET), whereas 164 were defined as nonviable; 300 normal segments on SPECT/PET among 352 segments without abnormal motion on routine echocardiography were categorized as a control group. The radial, longitudinal, 3D, and area strain on 3D speckle-tracking echocardiography had significant differences between control and nonviable groups (P < .001), whereas none of the parameters had significant differences between control and viable groups. There were no significant differences in circumferential, radial, and longitudinal peak systolic strain from 2D speckle-tracking echocardiography between viable and nonviable groups. Although there was no significant difference in circumferential strain between the groups, radial and longitudinal strain from 3D speckle-tracking echocardiography decreased significantly in the nonviable group. Moreover, 3D and area strain values were lower in the nonviable segments than the viable segments. By receiver operating characteristic analysis, radial strain from 3D speckle-tracking echocardiography with a cutoff of 11.1% had sensitivity of 95.1% and specificity of 53.4% for viable segments; longitudinal strain with a cutoff of 14.3% had sensitivity of 65.2% and specificity of 65.7%; 3D strain with a cutoff of 17.4% had sensitivity of 70.6% and specificity of 77.2%; and area strain with a cutoff of 23.2% had sensitivity of 91.5% and specificity of 82.8%.


CONCLUSIONS
Three-dimensional speckle-tracking echocardiography might have potential for detection of myocardial viability in patients with cardiac dysfunction due to MI.
Department of Echocardiography, Nanjing First Hospital, affiliated with Nanjing Medical University, Nanjing, China.
Hong
H
Ran
Department of Echocardiography, Nanjing First Hospital, affiliated with Nanjing Medical University, Nanjing, China zhpy28@hotmail.com.
Ping-Yang
PY
Zhang
Department of Echocardiography, Nanjing First Hospital, affiliated with Nanjing Medical University, Nanjing, China.
You-Xiang
YX
Zhang
Department of Echocardiography, Nanjing First Hospital, affiliated with Nanjing Medical University, Nanjing, China.
Jian-Xin
JX
Zhang
Department of Echocardiography, Nanjing First Hospital, affiliated with Nanjing Medical University, Nanjing, China.
Wen-Fang
WF
Wu
Department of Echocardiography, Nanjing First Hospital, affiliated with Nanjing Medical University, Nanjing, China.
Jing
J
Dong
Department of Echocardiography, Nanjing First Hospital, affiliated with Nanjing Medical University, Nanjing, China.
Xiao-Wu
XW
Ma
D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology
3-dimensional speckle-tracking echocardiography; echocardiography; myocardial viability; strain