Assessment of myocardial damage after acute myocardial infarction by diastolic deceleration time of coronary flow velocity using echocardiography and contrast-enhanced magnetic resonance imaging.

Abstract

There are limited data available regarding the use of diastolic deceleration time (DDT) of three major arteries measured by transthoracic echocardiography (TTE) for assessing coronary microvascular damage after acute myocardial infarction (AMI). Therefore, we aimed to compare the DDT of three major arteries using TTE with the transmural extent of infarction (TEI) and infarct size, which were classified using contrast-enhanced magnetic resonance imaging (CE-MRI), in patients with AMI. The DDT of the culprit coronary artery was measured in 74 patients using TTE and CE-MRI 1week after the onset of AMI. The TEI was graded based on the transmural extent of the hyper-enhanced tissue (grades 1-4). The assessable rate for the DDT was 95%; individual rates were 100% for the left anterior descending coronary artery, 90% for the left circumflex artery, and 93% for the right coronary artery. The DDT decreased gradually as the TEI grade progressed (P=.021). Infarct size was significantly correlated with the DDT (r=-0.51, P<.0001). Univariate analysis revealed that the left ventricular (LV) end-systolic volume, LV ejection fraction, and DDT were significantly associated with TEI grade 4. After adjustment via multiple logistic regression analysis, the DDT was independently remained. With a cutoff value of 950ms, as determined by the ROC curve, DDT could detect TEI grade 4 with 81.1% sensitivity and 80.1% specificity. The DDT of three major coronary arteries measured by TTE 1week after the onset of AMI can assess the extent of myocardial damage, which is determined by CE-MRI.