Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients After Myocardial Infarction

摘要

Background: Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy, and deteriorating function, which if uninterrupted leads to congestive heart failure (CHF) and a poor clinical outcome, begins in some patients with acute myocardial infarction (AMI) even after successful percutaneous coronary intervention (PCI). Aims: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four acute myocardial infarction patients. A thorough physical examination, electrocardiography (ECG) and a complete echocardiographic assessment, including speckle tracking study, was performed two days after PCI and then a follow up echocardiography with speckle tracking study was done two months afterwards. Patients were then divided into two groups based on the presence of remodelling (R+, R-). RESULTS: at baseline study global longitudinal strain (GLS) (-11.14±0.5 VS -16.78±0.4, P0.0001), longitudinal strain rate (LSr) (-1.01±0.05 VS -1.07±0.04, P0.0001), culprit longitudinal strain (CulLS) (-9.74±0.59 VS - 15.68±0.49, P0.0001), culprit longitudinal strain rate (CulLSr) (-0.95±0.05 VS -1.02±0.04, P0.0001) were all lower in group R+ than in R-. In the follow up study, all strain parameters studied were significantly lower in the R+ group than R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively) and (specificities of 95% and 96.7% respectively). CONCLUSION: Our findings show that impaired indices LV deformation detected two days after successful PCI for AMI may provide predictive value in detecting LV remodelling.