Value of 3-Dimensional Speckle Tracking Echocardiography in the Prediction of Microvascular Obstruction and Left Ventricular Remodeling in Patients With ST-Elevation Myocardial Infarction

Akinori Sugano; Yoshihiro Seo; Tomoko Ishizu; Hiroaki Watabe; Masayoshi Yamamoto; Tomoko Machino-Ohtsuka; Yui Takaiwa; Yuki Kakefuda; Hideaki Aihara; Yuko Fumikura; Hidetaka Nishina; Yuichi Noguchi; Kazutaka Aonuma

doi:10.1253/circj.CJ-16-0944

Ischemic Heart Disease

Value of 3-Dimensional Speckle Tracking Echocardiography in the Prediction of Microvascular Obstruction and Left Ventricular Remodeling in Patients With ST-Elevation Myocardial Infarction

Akinori Sugano, Yoshihiro Seo, Tomoko Ishizu, Hiroaki Watabe, Masayoshi Yamamoto, Tomoko Machino-Ohtsuka, Yui Takaiwa, Yuki Kakefuda, Hideaki Aihara, Yuko Fumikura, Hidetaka Nishina, Yuichi Noguchi, Kazutaka Aonuma

Author information

Akinori Sugano
Cardiovascular Division, Faculty of Medicine, University of Tsukuba
Yoshihiro Seo
Cardiovascular Division, Faculty of Medicine, University of Tsukuba
Tomoko Ishizu
Cardiovascular Division, Faculty of Medicine, University of Tsukuba
Hiroaki Watabe
Cardiovascular Division, Faculty of Medicine, University of Tsukuba
Masayoshi Yamamoto
Cardiovascular Division, Faculty of Medicine, University of Tsukuba
Tomoko Machino-Ohtsuka
Cardiovascular Division, Faculty of Medicine, University of Tsukuba
Yui Takaiwa
Department of Cardiology, Tsukuba Medical Center Hospital
Yuki Kakefuda
Department of Cardiology, Tsukuba Medical Center Hospital
Hideaki Aihara
Department of Cardiology, Tsukuba Medical Center Hospital
Yuko Fumikura
Department of Cardiology, Tsukuba Medical Center Hospital
Hidetaka Nishina
Department of Cardiology, Tsukuba Medical Center Hospital
Yuichi Noguchi
Department of Cardiology, Tsukuba Medical Center Hospital
Kazutaka Aonuma
Cardiovascular Division, Faculty of Medicine, University of Tsukuba

Keywords: Acute myocardial infarction, Microvascular obstruction, 3-dimensional speckle tracking echocardiography, Ventricular remodeling

JOURNAL FREE ACCESS FULL-TEXT HTML

2017 Volume 81 Issue 3 Pages 353-360

DOI https://doi.org/10.1253/circj.CJ-16-0944

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Abstract

Background:In patients with myocardial infarction (MI), microvascular obstruction (MVO) determined by cardiac magnetic resonance imaging (CMR) is associated with left ventricular (LV) remodeling and worse prognosis.

Methods and Results:In 71 patients with ST-segment elevation MI (STEMI) treated by primary percutaneous coronary intervention (PCI), speckle tracking echocardiography (STE) and CMR were performed early after PCI. All patients underwent CMR at 6 months after hospital discharge to assess the occurrence of LV remodeling. The values of 3-dimensional (3D)-circumferential strain (CS), area change ratio (ACR), and 2-dimensional (2D)-CS were significantly different for the transmural extent of infarct, whereas the values of 3D- and 2D- longitudinal strain (LS) were not significantly different. In transmural infarct segments, the values of 3D-CS and ACR were significantly lower in segments with MVO than in those without MVO. At 6-month follow-up, LV remodeling was observed in 22 patients. In multivariable logistic regression models, global 3D-CS and ACR were significant determinants of LV remodeling rather than the number of MVO segments.

Conclusions:Regional 3D-CS and ACR reflected the transmural extent of infarct and were significantly associated with the presence of MVO. In addition, global 3D-CS and ACR were preferable to the extent of MVO in the prediction of LV remodeling.

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