Abstract 11330: Layer Specific Quanti[[Unable to Display Character: ﬁ]]cation of Myocardial Deformation by Strain Echocardiography May Detect Micro Vascular Obstruction and Hemorrhage in Patients With Acute Myocardial Infarction After Reperfusion
Background: The myocardial reperfusion injury can paradoxically reduce the beneficial effects of myocardial reperfusion. We sought to detect the reperfusion injury using parameters of layer-specific myocardial deformation in patients with acute myocardial infarction (MI) after intervention therapy.
Methods: Two-D speckle tracking echocardiography (2DSTE) was performed in 81 patients (mean age 57±9 years, 76 men) with acute MI after primary percutaneous coronary intervention (PCI). The peak systolic myocardial segmental layer longitudinal (LS) and circumferential (CS) strains were assessed by 2DSTE using an 18-segment model of left ventricle. The micro vascular obstruction (MVO) and intramyocardial haemorrhage (IMH) were determined by contrast-enhanced cardiac magnetic resonance imaging(ceCMR).
Results: There were 422/1,458 segments with transmural necrosis in 81 patients. There were 58 patients with MVO and 46 patients with IMH. The amplitudes of myocardial layers LS and CS were significantly decreased in order of the segments with transmural necrosis [MVO(-)IMH(-)], MVO or/and IMH (p< 0.0001) (Table). The changes of layer LS and CS from endo- to epicardium correlated with MVO ( LS: r=-0.43, -0.47, -0.48 ; p<0.0001; CS: r=-0.52, -0.53, -0.51; p<0.0001) and IMH ( LS: r=-0.37, -0.41, -0.41; p<0.0001; CS: r=-0.46, -0.47, -0.45; p<0.0001).The LV segmental dysfunction of infarction area was exacerbated by MVO or/and IMH.
Conclusion: Our study indicated that the reperfusion injury-IMH and MVO’s was shown to exhibit a significantly negative impact on regional function. The parameters of layer specific myocardial deformation might be a helpful tool to detect reperfusion injury in patients with acute MI after PCI.
Author Disclosures: X. Yang: None. Z. Qiao: None. J. Sun: None. H. Zhao: None. H. Ge: None. X. Shen: None. Z. Li: None. C. Wei: None. J. Pu: None. B. He: None. C. Yu: None.
- © 2014 by American Heart Association, Inc.