Assessment of Left Ventricular Dyssynchrony in Myocardial Infarction Using 2D Speckle Tracking Imaging

Abstract

Background. The assessment of left ventricular (LV) dyssynchrony is increasingly important in clinical cardiology.Methods. The aim of this study was to evaluate LV dyssynchrony in patients with myocardial infarction (MI) using 2D speckle tracking imaging. Basal, middle and apical 2D LV short-axis images were acquired in 41 patients with MI and in 15 age-matched controls. Using 2D strain software, radial strain, circumferential strain, time interval from the R wave on the electrocardiogram to peak radial strain (Trs), and time to peak circumferential strain (Tcs) were measured in 6 segments at each level. To assess LV dyssynchrony, the following dyssynchrony indices were calculated: Trs(cs)-18SD: the standard deviation (SD) of Trs(cs) in all 18 segments, Trs(cs)-12SD: the SD of Trs(cs) in 6 basal and 6 mid segments, Trs(cs)-6SD: the SD of Trs(cs) in 6 basal segments.Results. Trs(cs)-18SD was significantly prolonged in the MI group when compared to age-matched controls. Trs(cs)-18SD was significantly longer compared to Trs(cs)-12SD or Trs(cs)-6SD in patients with anterior wall MI. Trs(cs)-18SD was significantly longer in patients with anterior wall MI compared to those with inferior wall MI.Conclusions. Myocardial infarction has results in the development of LV dyssynchrony. Both the size and the location of MI affect the extent of LV mechanical dyssynchrony. 2D speckle tracking imaging has a potential for accurate assessment of LV dyssynchrony in the LV short-axis views.