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ȣ - 520576 285 |
| Early prediction of myocardial viability after acute myocardial infarction by 2-dimensional speckle tracking image
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| 경희대학교 의과대학 순환기 내과학교실 |
| 유태경, 김우식, 우종신, 하상진, 황석재, 손일석, 김수중, 조진만, 김명곤, 김종진, 배종화, 김권삼 |
Background This study was to assess myocardial viability by speckle tracking imaging in patients with acute myocardial infarct (AMI) and compared initial parameters with 6 months follow-up dobutamine echocardiography (dbE).
Methods Standard and speckle tracking echocardiography were performed in 19 patients with AMI at admission, 3 days after primary coronary intervention and compared with 6 months follow-up dbE.
Results Among infarct-related segments viable segments were 69, nonviable segments were 22. There was significant difference between viable and nonviable segments in peak lengthening strain (ε-L; 2.6±2.6, 5.1±5.4, p<0.05), peak systolic strain (ε-peak; -13.0±6.9, -6.6±3.2, p<0.05), lengthening-shortening strain (LS) ratio (0.2±0.2, 0.4±0.3, p<0.05), postsystolic shortening (PSS; 3.4±3.9, 5.9±3.4, p<0.05), peak systolic strain rate (SSR; -0.9±0.5, -0.5±0.2, p<0.05), and early diastolic strain rate (ESR; 0.8±0.6, 0.5±0.4, p<0.05) at initial presentation. No increment
of parameters after low-dose dbE were also observed in nonviable segments (table). In the multivariate logistic regression anaylsis, initial LS ratio, SSR, and no increment of SSR after dbE were independent predictor of nonviable segments (table).
Conclusion Speckle tracking imaging were feasible, and useful to assess myocardial viability in patients of AMI.
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Univariate analysis |
Multivariate analysis |
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p value |
Hazard ratio (95%Cl) |
p value |
Hazard ratio (95%Cl) |
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Before PCI
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ε-L, % |
< 0.05 |
1.202 (1.073-6.320) |
0.439 |
- |
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ε-peak, % |
< 0.001 |
1.300 (1.750-12.124) |
0.109 |
- |
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LS ratio |
< 0.001 |
64.688 (1.222-11.648) |
< 0.05 |
43.876 (1.736-4.742) |
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PSS % |
< 0.05 |
1.158 (1.610-5.759) |
0.086 |
- |
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SSR, s-1 |
< 0.001 |
41.300 (1.123-10.977) |
< 0.05 |
18.116 (1.211-5.720) |
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ESR, s-1 |
< 0.05 |
4.596 (1.595-4.596) |
0.886 |
- |
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ASR, s-1 |
0.137 |
- |
- |
- |
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After PCI |
no increment of SSR |
< 0.05 |
1.370 (1.399-1.623) |
< 0.05 |
3.688 (1.584-4.985) |
Table Univariate and Multivariate analysis in viable and nonviable segments
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