Abstract
The aim of this study was to investigate if there was an association between infarct size (IS) measured by cardiac magnetic resonance (CMR) and echocardiographic global longitudinal strain (GLS) in the early stage of acute myocardial infarction in patients with preserved left ventricular ejection fraction (LVEF). Patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were assessed with CMR and transthoracic echocardiogram within 1 week of hospital admission. Two-dimensional speckle tracking was performed using a semi-automatic algorithm (EchoPac, GE Healthcare). Longitudinal strain curves were generated in a 17-segment model covering the entire left ventricular myocardium. GLS was calculated automatically. LVEF was measured by auto-LVEF in EchoPac. IS was measured by late gadolinium enhancement CMR in short-axis views covering the left ventricle. The study population consisted of 49 patients (age 60.4 ± 9.7 years; 92% male). The study population had preserved echocardiographic LVEF with a mean of 45.8 ± 8.7%. For each percent increase of IS, we found an impairment in GLS by 1.59% (95% CI 0.57–2.61), P = 0.02, after adjustment for sex, age and LVEF. No significant association between IS and echocardiographic LVEF was found: −0.25 (95% CI: −0.61 to 0.11), P = 0.51. At the segmental level, the strongest association between IS and longitudinal strain was found in the apical part of the LV: impairment of 1.69% (95% CI: 1.14–2.23), P < 0.001, for each percent increase in IS. In conclusion, GLS was significantly associated with IS in the early stage of acute myocardial infarction in patients with preserved LVEF, and this association was strongest in the apical part of the LV. No association between IS and LVEF was found.
Highlights
MethodsClinical outcomes after an acute myocardial infarction (AMI) are determined by the initial morphological and functional alterations resulting from myocardial necrosis [1, 2, 3]
The aim of this study was to investigate the association between Infarct size (IS) measured by Cardiac magnetic resonance (CMR) and echocardiographic global longitudinal strain (GLS) in patients with ST-segment elevation myocardial infarction (STEMI) and preserved Left ventricular ejection fraction (LVEF)
We found that the association between IS and GLS was strongest in the apical level, where we found an impairment in GLS by 1.69% (1.14–2.24) for each percent of higher IS, P < 0.001
Summary
MethodsClinical outcomes after an acute myocardial infarction (AMI) are determined by the initial morphological and functional alterations resulting from myocardial necrosis [1, 2, 3]. Compared to other imaging modalities, CMR offers multiparametric high-resolution assessment of myocardial structure, function and viability, including detection of small infarcts [8, 9, 10, 11]. A significant rate of sudden cardiac deaths (SCD) following AMI occurs in patients with LVEF >35% and within the first 30 days after discharge from hospital [13, 14].
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