Abstract 13407: Association Between Left Ventricular Global Longitudinal Systolic Strain and Impaired Microcirculation in Patients With Acute Myocardial Infarction.
Background. The association between left ventricular global longitudinal systolic strain (GLS) and coronary flow reserve (CFR) assessed by transthoracic echocardiography has never been investigated. We analyzed this in patients with acute myocardial infarction (AMI).
Methods. In consecutive first time AMI patients, who underwent successful revascularization, we performed comprehensive 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 patients (49%) had a non-ST-elevation myocardial infarction and 94 patients (51%) had a ST-elevation myocardial infarction. Echocardiography was performed a median of 5[2;9] days after admission. 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=-0.29, p<0.0001). Furthermore we found a strong correlation between CFR and GLS (r=-0.85, p<0.0001). This was also seen in the multivariate regression model adjusting for possible confounders including WMSI (p<0.001). By dividing 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 are associated with depressed left ventricular global longitudinal systolic function demonstrating an important patophysiological link between noninvasive estimation of coronary flow reserve and left ventricular function.
- © 2011 by American Heart Association, Inc.