Abstract 13585: Decreased Left Ventricular Global Longitudinal Systolic Strain in Patients With Acute Myocardial Infarction is a Strong Indicator of Decreased Microcirculation.
Objective: To analyze the association of left ventricular global longitudinal systolic strain (GLS) and coronary flow reserve (CFR) assessed by transthoracic echocardiography in patients with acute myocardial infarction (AMI).
Methods: In consecutive first time AMI patients, who underwent successful revascularization, we performed 2D echocardiography. GLS was obtained from the three standard apical views. Assessment of CFR by transthoracic echocardiography was performed in a modified apical view by color Doppler guidance.
Results: The study population consisted of 183 patients (51 females) with a median age of 63 [54;70] years. Eighty-nine had a non-ST-elevation myocardial infarction and 94 patients had a ST-elevation myocardial infarction. The echocardiographic was performed a median of 5[2;9] days after the verified diagnosis of AMI. GLS was −15.2[−19.3;−10.1] in the total population. Total wall motion score index (WMSI) in the population was 1.19 [1;1.5] . The GLS correlated with WMSI (r=0.37). Furthermore we found a strong correlation between CFR and GLS (r=−0.79). In a univariate logistical regression model we found a highly significant association (p<0.001). This was also seen in the multivariate regression model adjusting for possible confounders including WMSI (p<0.001). By splitting the population by CFR ≤2 (109 patients) and CFR >2 (74 patients) we found a significant difference in GLS (−11.8 [−14.9;−8.3] vs. −19.8[−21.9;−17.8], p<0.0001).
Conclusions: This study indicates that disturbances in microvascular circulation affect left ventricular global longitudinal systolic strain and may indicate that GLS is a sensitive echocardiographic tool to quantification of silent ischemia in the heart following an acute myocardial infarction.
- © 2010 by American Heart Association, Inc.