Usefulness of Ultrasonic Strain Measurements to Predict Regional Wall Motion Recovery in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention

Abstract

Strain Doppler echocardiography can detect systolic regional myocardial dysfunction. This study assessed whether strain could predict recovery of regional left ventricular function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention. Forty-three patients with anterior AMI undergoing successful percutaneous coronary intervention of the left anterior descending coronary artery were studied. Longitudinal myocardial strain was measured at the left anterior descending coronary artery territory in the apical long-axis view within 24 hours after percutaneous coronary intervention. Regional wall motion was analyzed by the anterior wall motion score index (A-WMSI). Viable myocardium was defined as a decrease < or = 2.0 in A-WMSI. Patients were categorized as A-WMSI at 4 weeks into a viable group (n = 24) and a nonviable group (n = 19). End-systolic strain and peak strain were significantly lower in the nonviable group than in the viable group (-4.8 +/- 4.8% vs -9.9 +/- 4.7 %, p <0.005; -9.9 +/- 4.6 vs -13.5 +/- 4.1 %, p <0.05). Moreover, corrected time to peak strain (cTPS; time delay from end-systolic to peak strain/RR interval) was significantly longer in the nonviable group than in the viable group (0.19 +/- 0.04 vs 0.13 +/- 0.03, p <0.0001). For prediction of viable myocardium, cTPS <0.15 had a sensitivity of 95% and a specificity of 85%. In conclusion, strain, especially cTPS, is useful for predicting recovery of regional left ventricular function in patients with AMI after percutaneous coronary intervention.