Informativeness of echocardiography in inferior myocardial infarction at different stages of observation

Abstract

Aim. to evaluate the informativeness of echocardiographic parameters in patients with acute inferior wall myocardial infarction of the left ventricle, who have undergone primary percutaneous coronary intervention, at discharge from the hospital and in the long-term period. Material and methods. Echocardiographic data was analyzed using speckle tracking technology in 144 patients with acute inferior myocardial infarction of the left ventricle before discharge and 2 years later. In the post-infarction period, 10 patients underwent magnetic resonance imaging and 15 patients underwent stress echocardiography. Results. Using the tree construction method, critical values of 7 ultrasound parameters were identified (for the left ventricle - ejection fraction, end-systolic volume index, global longitudinal and circular strains, for the right ventricle - tricuspid S', global longitudinal strain, free wall strain), which with a probability of 89.4% predict repeat revascularization. Identification of possible areas of myocardial fibrosis in the remote period by speckle-tracking echocardiography has a sensitivity of 46-57%, specificity of 68-76%, and negative predictive value of 74-87% relative to the gold standard detection of postinfarction scarring by magnetic resonance imaging. According to the results of stress-echocardiography, new zones of local contractility impairment registered after exercise were not accompanied by changes in segmental longitudinal deformation. Conclusion. The results of echocardiographic screening of patients with acute inferior myocardial infarction of the left ventricle using speckle tracking technology have high prognostic significance in assessing the likelihood of repeated revascularization at discharge and diagnostic information for verifying post-infarction fibrous changes in the long-term period.