title: Impact of area strain by 3D speckle tracking on clinical outcome in patients after acute myocardial infarction.
abstract: BACKGROUND
  Three-dimensional (3D) speckle tracking echocardiography (STE) has been developed to overcome the limitations of two-dimensional (2D) STE and has been applied in the several clinical settings. However, no data exist about the prognostic value of 3DSTE-based strain on clinical outcome after myocardial infarction (MI). This study was designed to investigate the prognostic value of area strain (AS) by 3D speckle tracking in predicting clinical outcome after acute MI.
  
  
  METHODS
  We assessed 96 patients (62±14 years, 72% male) with acute MI and who had undergone a coronary angiography. Clinical parameters and conventional echocardiographic measurements including the left atrial (LA) size and tissue Doppler measurements were evaluated. The global left ventricular (LV) AS was measured using 3D speckle tracking software. The relationship between the AS and clinical outcome of death or hospitalization for heart failure (HF) was assessed.
  
  
  RESULTS
  During a median follow-up of 33±10 months, primary endpoint of death or HF occurred in 12 patients (12.5%). AS was predictive of death or HF after adjustment for age, gender, peak CK-MB, LA volume, LV end-systolic volume, LV mass, the ratio of early mitral inflow velocity to early mitral annular velocity, and LV ejection fraction in a multivariate Cox model (HR 1.23, 95% CI 1.02-1.47, P=.03). In addition, AS added incremental value in predicting death or heart failure on a model based on clinical and standard echocardiographic measures (P=.008).
  
  
  CONCLUSIONS
  AS is independently associated with increased risk of death or HF after acute MI, suggesting that it can be a useful prognostic parameter in the patients following MI.
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Sung-Hee
authors: SH
authors: Shin
authors: Institute of Clinical Research, Inha University College of Medicine, Incheon, South Korea.
authors: Young Ju
authors: YJ
authors: Suh
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Yong-Soo
authors: YS
authors: Baek
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Man-Jong
authors: MJ
authors: Lee
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Sang-Don
authors: SD
authors: Park
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Sung-Woo
authors: SW
authors: Kwon
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Seong-Ill
authors: SI
authors: Woo
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Dae-Hyeok
authors: DH
authors: Kim
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Keum-Soo
authors: KS
authors: Park
authors: Division of Cardiology, Inha University College of Medicine, Incheon, South Korea.
authors: Jun
authors: J
authors: Kwan
mesh_terms: D017023:Coronary Angiography; D015150:Echocardiography, Doppler / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D011379:Prognosis; D015203:Reproducibility of Results; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology
keywords: acute myocardial infarction; area strain; clinical outcome; three-dimensional speckle tracking