Abstract 11536: Clinical Usefulness of Twisting Motion Estimated by 3D Speckle Tracking Strain Acutely After Onset of ST-Elevation Myocardial Infarction
Background: 3D speckle tracking echocardiography (3D tracking) is a novel promising tool that can accurately assess twisting motions (Twist, Torsion ). Twisting motion can provide a unique and useful estimation of cardiac function, but it should be measured using 3D tracking.
Methods: The study included 190 consecutive patients (162 men, 64.7±11.9 years, peak CPK=3050 ± 3457U/l) presenting with a first STEMI who underwent primary PCI within 12 hours of onset. Within 24 hours of PCI, 2D and 3D speckle tracking echocardiography were measured by iE33 and analyzed by Q-lab version 9.0 (CMQ, Philips) and 4D LV-Analysis (TOM-TEC, Germany). Final infarct size was defined using Tc99m-sestamibi as the total area of <50%uptake area at 2 weeks and an left ventricular (LV) ejection fraction (EF) was also determined. Echocardiography was repeated 12 months later and LV remodeling was defined as an absolute increase in LVEDV of 20%.
Results: Both Twis t and Torsion estimated by the 3D speckle tracking echocardiography had a significant relationship with infarct size (r= -0.26, r= -0.24, p<0.01, respectively) and EF by MIBI (r= 0.31, r=0.33, p<0.01, respectively). Furthermore, both motions could predict LV remodeling at 12 months (Twist: Odds ratio=1.011, 95%CI 1.003-1.018, p<0.01, Torsion: 1.060, 95%CI 1.001+1.126, p<0.01,) and had good relationship with BNP at 12 moths(r= -0.24,r= -0.23 p<0.05, respectively).
Conclusions: In patients with a first STEMI, a decreased LV twisting motion (Twist, Torsion ) assessed by 3D speckle tracking echocardiography immediately after PCI had a significant association with the final infarct size and EF at 2 weeks; furthermore, twisting could predict LV remodeling after 12 months.
- © 2013 by American Heart Association, Inc.