Validity of resting strain/strain rate in prediction of myocardial viability.

Amr Hanafy,Hossam-Eldein Mohamed Mohamed Mansour,Mohamed Kamal Salama,Soliman Ghareb Ibrahim,Aml Mohamed Soliman

doi:10.1007/s10554-021-02416-8

Abstract

To evaluate the validity of the resting strain/strain rate measurements in predicting myocardial viability taking delayed enhancement cardiac magnetic resonance imaging as the gold standard. A cohort of 60 patients at three months followed up after acute myocardial infarction were recruited for this study. Resting echocardiography with offline analysis of deformation indices and gadolinium contrast enhanced cardiac magnetic resonance imaging were applied for all patients. For the final assessment, 268 segments with significant resting wall motion abnormalities were presented. Resting longitudinal strain was significantly (p < 0.05) higher in viable, compared with non-viable segments in all the studied individual myocardial segments (apical inferior, mid antro-lateral, mid-inferolateral, mid inferoseptum, and all other segments). Likewise, resting longitudinal strain rate was significantly (p < 0.05) higher in viable, compared with non-viable segments in almost all studied individual myocardial segments apart from apical inferior, mid inferolateral and basal antro-septum (p = 0.245, p = 0.098, p = 0.097 respectively). Resting Strain and Resting Strain rate could be used as accurate predictors of myocardia viability following acute myocardial infarction.

Highlights

Patients with ischemic heart disease (IHD) and left ventricular dysfunction (LVD) carry poor prognosis [1]
Resting Strain and Resting Strain rate could be used as accurate predictors of myocardia viability following acute myocardial infarction
Several non-invasive modalities (such as single photon emission computed tomography (SPECT), dobutamine stress echocardiography (DSE), positron emission tomography (PET) and Cardiac Magnetic Resonance Imaging (CMR)) [3] have been approved to determine patients with viable myocardium, who will most benefit from revascularization [2]

Summary

Introduction

Patients with ischemic heart disease (IHD) and left ventricular dysfunction (LVD) carry poor prognosis [1]. Myocardial dysfunction improves significantly with revascularization and prognosis improves [2]. Several non-invasive modalities (such as single photon emission computed tomography (SPECT), dobutamine stress echocardiography (DSE), positron emission tomography (PET) and Cardiac Magnetic Resonance Imaging (CMR)) [3] have been approved to determine patients with viable myocardium, who will most benefit from revascularization [2]. Out of the newly validated methods for assessment of myocardial viability, DSE was the most widely available approach [4] with an overall similar sensitivity compared with other non-invasive imaging modalities and highest specificity [5]. Its subjectivity limits its diagnostic value as its liable for inter-observer and intra-observer variability [6]. Some researchers explored the potentiality of adding deformation indices measurement to DSE protocol in the atrial function to overcome its subjectivity and the results were promising [7,8,9]

Methods

Results

Conclusion