Abstract 12230: Estimation of Acute Onset Global Longitudinal Strain by 3D Speckle Tracking After ST-Elevation Myocardial Infarction is Useful for Predicting Left Ventricular Remodeling
Background: Left ventricular (LV) global strain estimated immediately after ST elevation AMI (STEMI) was reported as a predictor of LV remodeling. However, strain analysis ideally should be assessed by 3D speckle tracking, in order to avoid through plane motion. We explored the usefulness of global strain estimated by 3D speckle tracking in patients with a first STEMI in comparison with infarct size estimated by Tc99m-sestamibi.
Methods: 239 consecutive patients (194 men, age 65 years, peak CPK=3132±3817 IU/l) presenting with a first ST-elevation AMI (STEMI) who underwent primary PCI within 12 hours of onset were enrolled. Within 24 h of PCI, echocardiography were performed by E33. 3D speckle tracking was analyzed by 4D LV-Analysis (TOM-TEC, Germany). Global longitudinal strain (GLS) was calculated; 3D (3D-GLS). Final infarct size was defined using Tc99m-sestamibi as the total area of <50%uptake area at 2 weeks. Echocardiography was repeated 12 months later and LV remodeling was defined as an absolute increase in LVEDV of more than 20%. The patients with Af, HD, prior MI, and emergency CABG were excluded.
Results: LV remodeling was observed in 54 patients at 12 months. Both 3D-GLS and Tc99m-sestamibi had significant correlations with LV remodeling. (Table) Multivariate analysis showed that 3D-GLS was the stronger predictor for LV remodeling compared with the infarct size estimated by Tc99m-sestamibi.
Conclusions: In patients with a first STEMI, GLS assessed by 3D speckle tracking echocardiography immediately after PCI can predict LV remodeling. It was stronger than infarct size estimated by Tc99m-sestamibi to predict LV remodeling.
Author Disclosures: N. Iwahashi: None. M. Gohbara: None. E. Akiyama: None. N. maejima: None. K. Tsukahara: None. K. Hibi: None. M. Kosuge: None. T. Ebina: None. S. Umemura: Research Grant; Modest; Torii. Research Grant; Significant; Pfizer, Dainippon-Sumitomo, Astellas, Shionogi, Daiichi-Sankyo, MSD, Astrazeneca, Novartis, Nihon-Boehringer-Ingelheim. Honoraria; Modest; Shionogi, MSD, Kyowa-Hakko-Kirin. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd, Bayer, MSD, Astellas, Astrazeneca, Sanofi, Eli Lilly Japan, Research Institute for Production Development, Novartis, Bayer, Pfizer, Shionogi, Kowa-souyaku, Daiichi-Sankyo, Mitsubishi Tan. Honoraria; Modest; Astrazeneca. Honoraria; Significant; MSD.
- © 2014 by American Heart Association, Inc.