Abstract
The aim was to compare the speckle tracking echocardiography (STE) derived systolic longitudinal strain (SL(Smax)) with rest single photon emission computed tomography (SPECT) perfusion imaging (Q(REST)), and to define the optimal cut-offs for SL(Smax) to discriminate transmural scar on contrast-enhanced magnetic resonance imaging (ceCMR). In 100 patients with chronic ischemic left ventricular (LV) dysfunction, myocardial viability was assessed using STE and rest SPECT to predict LV segmental relative extent of delayed enhancement (DE) >75% on ceCMR. Correlation was found between regional SL(Smax) (r=-0.59, P<0.0001) and DE on ceCMR. The SL(Smax) optimal cut-off -5.3% identified segments with DE>75% on ceCMR (sensitivity 83.1%, specificity 84.6%). Optimal cut-offs SL(Smax) for segments corresponding to individual perfusion territories (-3.6%, -5.3% and -4.7% for LAD, LCx resp. RCA perfusion territories) were identified. There was a significant difference (AUC 0.866 vs. 0.822 for SL(Smax) resp. Q(REST), p=0.036) in the accuracy of predicting non-viable segment due to the greater accuracy of SL(Smax) than Q(REST) in the RCA perfusion territory (AUC 0.893 vs. 0.75 for SLSmax resp. Q(REST), P=0.001). STE enabled identification of LV non-viable segments. Cut-off values derived for perfusion territories of individual coronary arteries improve the accuracy of predicting a transmural scar presence. In comparison with rest myocardial SPECT perfusion imaging, STE is more accurate in predicting non-viable myocardium.
Highlights
Ischemic cardiomyopathy is the most frequent cause of left ventricular (LV) systolic dysfunction with the heart failure syndrome[1]
In 1471 LV segments (92%) echocardiographic image quality allowed assessment of segmental function with speckle tracking echocardiography (STE) compared with rest single photon emission computed tomography (SPECT) perfusion imaging in predicting transmural scar tissue on contrast-enhanced magnetic resonance imaging (ceCMR) (DE >75%)
Myocardial deformation imaging based on 2-dimensional longitudinal peak systolic strain analysis could differentiate between viable myocardial tissue and a LV segment with transmural scar, as defined by delayed enhancement (DE) > 75% in patients with ischemic left ventricular systolic dysfunction
Summary
Ischemic cardiomyopathy is the most frequent cause of LV systolic dysfunction with the heart failure syndrome[1]. Contrast enhanced cardiac magnetic resonance (ceCMR) is considered as a reference imaging method in the diagnostics of myocardial viability in chronic ischemic heart disease. It has shown close correlation between the extent of delayed enhancement and myocardial scar size. The aim was to compare the speckle tracking echocardiography (STE) derived systolic longitudinal strain (SLSmax) with rest single photon emission computed tomography (SPECT) perfusion imaging (QREST), and to define the optimal cut-offs for SLSmax to discriminate transmural scar on contrast-enhanced magnetic resonance imaging (ceCMR). In 100 patients with chronic ischemic left ventricular (LV) dysfunction, myocardial viability was assessed using STE and rest SPECT to predict LV segmental relative extent of delayed enhancement (DE) >75% on ceCMR. In comparison with rest myocardial SPECT perfusion imaging, STE is more accurate in predicting non-viable myocardium
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
