Comparison of pre and post Global longitudinal Strain imaging in thrombolytic and primary percutaneous coronary intervention in acute ST elevation Anterior Myocardial infarction

Abstract

Introduction: Myocardial hypokinesia is assessed by Echocardiography which is a non-invasive method.1,2 This technique, based on two-dimensional visual evaluation of endocardial wall thickening, is subjective. Inter-observer variability is more as it is dependent on operator experience. 3,4 and may not identify small but clinically significant changes in myocardial function that are below the threshold of visual resolution.5 Tissue Doppler imaging provides a more objective assessment of myocardial contractility but is subject to the confounding effects of cardiac translational motion and passive pathological tethering.6 These limitations may be overcome by the measurement of local myocardial deformation parameters with strain and strain rate echocardiography. Strain rate is defined as the rate of deformation in response to an applied force and is determined from the spatial gradient of local myocardial tissue velocities between two points which is calculated from the time integral of strain rate and reflects the magnitude of deformation.7,8 These parameters are potentially more accurate and specific measures of local myocardial function and may offer an opportunity to improve the detection of regional abnormalities.8,9 This study was designed to determine the role of Global longitudinal strain (GLS) in the detection functional ischaemic zone and assessed myocardial contractility following successful thrombolysis and primary percutaneous coronary intervention (PCI) and compare in between two groups.