Feasibility of initial post-systolic to systolic strain rate ratio as a predictor for viability of the ischemic myocardium with acute ST-elevation myocardial infarction

Abstract

Purpose: To investigate the strain index of viability on the ischemic myocardium with acute ST-elevation myocardial infarction (STEMI). Methods: Fifty-seven patients with acute STEMI were collected and assessed by 2D speckle-tracking echocardiography strain and strain rate imaging prior to urgent revascularization at acute phase and one year follow-up of post-revascularization. At acute phase, all myocardial segments were divided by their acute end-systolic strain (Ses) into those with normal (Ses; ≤ –13%), hypocontractile (–13% –7%). At the one year of follow-up, we re-assessed the recovery of severe contractile abnormality. Viability of these segments was defined as improved Ses (≤ –7%) after post-revascularization at follow-up. Results: Ses, post-systolic shortening index (PSI) and strain rate (SR) were significantly better in the viable than in the non-viable segments at both acute phase and follow-up (p<0.001). Initial post-systolic to systolic SR ratio (SRps/SRs) had the best AUC 0.897, and a cut-off value of 0.6 predicted recovery from severe contractile abnormality with a sensitivity of 75% and specificity of 88%. View this table: Comparison of accuracy for strain rate parameters Conclusions: Initial SRps/SRs could identify viability for the ischemic myocardium with acute STEMI.