Abstract 13141: Three-Dimensional Speckle-Tracking Longitudinal-Strain Predicts Improvement of Left Ventricular Function After Acute Myocardial Infarction
Introduction: Identification of patients with reversible left ventricular (LV) dysfunction is important for risk stratification after acute myocardial infarction (AMI). Three-dimensional (3D) speckle-tracking imaging has recently been introduced as a novel method for quantification of regional and global LV function.
Hypothesis: We tested the hypothesis that LV segmental and global longitudinal strain assessed by novel 3D speckle-tracking analysis is a predictor of functional improvement after AMI.
Methods: A total of 153 patients with AMI treated with primary percutaneous coronary intervention underwent real-time 3D echocardiography. LV segmental and global 3D longitudinal strain was assessed with speckle-tracking analysis using a novel dedicated software. At 6-month follow-up, improvement in segmental LV function was defined as a decrease ≥1 grade in wall motion score. Improvement in global LV function was defined as an absolute improvement ≥5% in LV ejection fraction.
Results: Segments with functional improvement at follow-up showed a significantly higher baseline segmental 3D longitudinal strain, as compared to segments without improvement (-16.4±4.0% vs -7.6±3.5%, p<0.001). A cutoff of -11.1% for segmental 3D longitudinal strain had 92% sensitivity and 91% specificity to predict segmental functional improvement. In addition, 67 (44%) patients showed a global LV functional improvement at 6-month follow-up. These patients had baseline global 3D longitudinal strain significantly higher as compared to patients without improvement (-16.7±2.1% vs -13.3±2.6%, p<0.001). At the multivariate logistic regression analysis, global 3D longitudinal strain provided incremental value over clinical and conventional echocardiographic variables in predicting global LV function improvement (C-statistic improved from 0.64 to 0.71 to 0.84, p<0.001).
Conclusions: 3D longitudinal strain is an important and independent predictor of LV functional improvement after AMI on both segmental and global level.
- © 2011 by American Heart Association, Inc.