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LONGITUDINAL STRAIN ASSESSED BY 2D SPECKLE TRACKING ECHOCARDIOGRAPHY PREDICTS MICROVASCULAR OBSTRUCTION IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION
A1173 JACC April 1, 2014 Volume 63, Issue 12
Non Invasive Imaging Longitudinal Strain Assessed by 2D Speckle Tracking Echocardiography Predicts Microvascular Obstruction in Patients with ST Elevation Myocardial Infarction Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: Myocardial Strain, Cardiac Mechanics and Diastolic Function Abstract Category: 15. Non Invasive Imaging: Echo Presentation Number: 1210-28 Authors: Zhiqing Qiao, Jing Ping Sun, Heng Ge, Alex Lee, Jun Pu, hang zhao, Jun Wang, Ben He, Xuedong Shen, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Prince of Wales Hospital, The Chinese University of Hong Kong, Hongkong, Hong Kong Background: Microvascular obstruction (MVO) following ST elevation myocardial infarction (STEMI) is associated with larger infarct size and an increased mortality. We hypothesized that longitudinal strain (LST) assessed by 2D speckle tracking echocardiography (2DSTE) could predict MVO after primary percutaneous coronary intervention (PCI). Methods: We enrolled 28 patients with first acute STEMI (Men 26, mean age 57±8 years) undergoing primary PCI. Culprit vessels were left anterior descending artery (LAD) in all subjects. 2DSTE and CMR were performed within 72 hours after PCI. LST of 17 myocardial segments were measured by automatic function imaging (AFI, Echo-PAC, GE). MVO was evident by late gadolinium enhancement (LGE) of CMR. Results: The LAD was successfully recanalized in all patients. The LST amplitude of LAD territory was significantly smaller than that of LCX and RCA territory (-5.8±5.4% vs 14.0±4.4% and -11.6±4.4%, respectively; p< 0.0001) after PCI. MVO within the anterior infarction was shown as LGE defect area in figure (A and B, arrow); which was detected in 21 of the 28 patients. The LST amplitude of LAD territory in patients with MVO was smaller than that in patients without MVO (-3.8±3.8% vs -11.8±5.1,p=0.0001; figure C and D). If using -6.9% as a cutoff point to predict the territory with MVO, the sensitivity and specificity were 81% and 86% (AUC= 0.91, p= 0.0001). Conclusions: LST by 2DSTE might be a predictor for MVO early in STEMI patients after primary PCI.
Non Invasive Imaging Longitudinal Strain Assessed by 2D Speckle Tracking Echocardiography Predicts Microvascular Obstruction in Patients with ST Elevation Myocardial Infarction Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: Myocardial Strain, Cardiac Mechanics and Diastolic Function Abstract Category: 15. Non Invasive Imaging: Echo Presentation Number: 1210-28 Authors: Zhiqing Qiao, Jing Ping Sun, Heng Ge, Alex Lee, Jun Pu, hang zhao, Jun Wang, Ben He, Xuedong Shen, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Prince of Wales Hospital, The Chinese University of Hong Kong, Hongkong, Hong Kong Background: Microvascular obstruction (MVO) following ST elevation myocardial infarction (STEMI) is associated with larger infarct size and an increased mortality. We hypothesized that longitudinal strain (LST) assessed by 2D speckle tracking echocardiography (2DSTE) could predict MVO after primary percutaneous coronary intervention (PCI). Methods: We enrolled 28 patients with first acute STEMI (Men 26, mean age 57±8 years) undergoing primary PCI. Culprit vessels were left anterior descending artery (LAD) in all subjects. 2DSTE and CMR were performed within 72 hours after PCI. LST of 17 myocardial segments were measured by automatic function imaging (AFI, Echo-PAC, GE). MVO was evident by late gadolinium enhancement (LGE) of CMR. Results: The LAD was successfully recanalized in all patients. The LST amplitude of LAD territory was significantly smaller than that of LCX and RCA territory (-5.8±5.4% vs 14.0±4.4% and -11.6±4.4%, respectively; p< 0.0001) after PCI. MVO within the anterior infarction was shown as LGE defect area in figure (A and B, arrow); which was detected in 21 of the 28 patients. The LST amplitude of LAD territory in patients with MVO was smaller than that in patients without MVO (-3.8±3.8% vs -11.8±5.1,p=0.0001; figure C and D). If using -6.9% as a cutoff point to predict the territory with MVO, the sensitivity and specificity were 81% and 86% (AUC= 0.91, p= 0.0001). Conclusions: LST by 2DSTE might be a predictor for MVO early in STEMI patients after primary PCI.