Abstract 2239: Can Strain Doppler Echocardiography Predict Viability in Patients with Acute Myocardial Infarction?
Background: Myocardial scar can be identified by delayed-enhanced cardiovascular magnetic resonance (CMR) while regional myocardial function can be assessed by strain Doppler echocardiography (SDE). The aim of this study was to test if SDE before reperfusion therapy could predict viability and degree of transmurality in infarcted segments as determined by CMR.
Methods and Results: Nineteen patients (61 ±12 years) with acute anterior myocardial infarction who underwent percutaneous coronary intervention (PCI) were included. SDE was performed before revascularization therapy. Peak systolic longitudinal strain by Doppler was analyzed in 12 LV segments. CMR with assessment of viability and scar extent was performed 9 months after reperfusion therapy. Strain measurements show normal systolic shortening (−15,7 ± 6,2%) in non-infarcted segments. There was reduced systolic shortening (−3.7 ± 10.4%) in LV segments with non-transmural scar extent and thus viable ischemic myocardium (Figure⇓, left panel). In contrast, systolic lengthening (1.7 ± 7.4%, p<0.001) was found in non-viable LV segments with transmural scars (left panel). Peak strain correlated well with the degree of transmurality of the myocardial scar in each segment (r=0.69, p<0.001; Figure⇓, right panel).
Conclusion: SDE performed before revascularization therapy by PCI can predict the transmural extent of ischemic injury and may distinguish between viable and non-viable myocardium.