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ȣ - 520589 97 |
| Decreased and delayed torsion and untwist in inferior wall myocardial infarction assessed by 2-dimensional speckle tracking image
: 6 month follow-up study after primary coronary intervention
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| 경희대학교병원 |
| 장정윤, ,하상진,김우식,황석재,손일석,조진만,김수중,김명곤,김종진,배종화,김권삼 |
Background:Left ventricular(LV) torsion from helically oriented myofibers is a key parameter of cardiac performance. The purpose of this study was to examine LV torsion and untwisting for assessment of myocardial function in patients with inferior wall myocardial infarction(MI) by 2-dimensional ultrasound speckle tracking imaging(STI) and compared these parameters with 6 month follow-up dobutamine echocardiography. Methods:Standard echocardiography and STI were performed in 27 patients with acute MI between initial presentation and 3 days after primary coronary intervention(PCI) and compared 6 months follow-up. Regional apical and basal rotations were obtained from apical and basal short axis views. LV torsion was calculated as the net difference between LV peak rotation angles divided by ventricular diastolic longitudinal length between the LV apex and the mitral plane. The degree of untwisting was expressed as percentage of peak systolic torsion. Results:Peak LV torsions in posterior and inferior segments were significantly reduced in the patients with inferior wall MI mainly because of reduced apical rotation. Global torsion, untwist at mitral valve opening time were also significantly reduced. Time to peak torsion in posterior and inferior segments were significantly delayed in patients with inferior wall MI. Conclusion:Systolic torsion and diastolic untwist were decreased in patients with inferior wall MI. After PCI, torsion and untwist were improved suggesting the significant impact of global LV function in patients with inferior wall MI.
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Initial presentation |
3 day after PCI |
6 month after PCI |
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Group A |
Group B |
Group A |
Group B |
Group A |
Group B |
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Posterior segment. |
Torsion |
1.41 ± 0.79 |
2.60±1.07* |
2.35 ± 0.75 |
2.42 ± 1.31 |
2.36 ± 0.98 |
2.23 ± 0.77 |
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Untwist |
0.44 ± 0.24 |
1.05±0.59* |
0.46 ± 0.29 |
0.46 ± 0.29 |
0.46 ± 0.28 |
0.48 ± 0.25 |
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Inferior segment |
Torsion |
1.67 ± 0.96 |
2.76±1.11 |
2.81 ± 0.79 |
2.69 ± 1.05 |
2.52 ± 0.87 |
2.64 ± 0.94 |
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Untwist |
0.38 ± 0.14 |
0.97±0.99* |
0.36 ± 0.24 |
0.40 ± 0.21 |
0.50 ± 0.17 |
0.50 ± 0.24 |
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Global |
Torsion |
1.47 ± 0.51 |
2.08±1.09 |
2.51 ± 1.01 |
2.23 ± 0.81 |
2.14 ± 0.59 |
2.29 ± 0.68 |
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Untwist |
0.35 ± 0.31 |
0.65±0.25* |
0.56 ± 0.38 |
0.41 ± 0.21 |
0.47 ±0.29 |
0.47 ± 0.24 |
*: p < 0.05, p value was analyzed between A and B groups.
Group A : inferior wall MI (n=8) Group B : non-inferior wall MI (n=19)
Values of torsion was degrees/cm and values of untwist was degrees.
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