{"title":"Longitudinal strain in patients with STEMI using speckle tracking echocardiography. Correlation with peak infarction mass and ejection fraction","authors":"Amira M. Ismail, Wael Samy, Randa Aly, Suzy Fawzy, Khaled Hussein","doi":"10.1016/j.ejccm.2015.10.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p>Our objective was to assess the global longitudinal peak systolic strain (GLPSS) by speckle tracking echocardiography (STE) in patients with STEMI in the first 24<!--> <!-->h after primary percutaneous coronary intervention (PCI) and its correlation with LV infarction size and ejection fraction.</p></div><div><h3>Methods and results</h3><p>A total of 30 patients with STEMI (mean age: 58<!--> <!-->±<!--> <!-->8<!--> <!-->years, 25 men) were studied. All patients underwent 1ry PCI. Conventional 2D echocardiography was performed to assess left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and end systolic volume index (ESVI), while STE was performed within 24<!--> <!-->h of 1ry PCI to assess LV GLPSS. Infarction size was estimated by myocardial perfusion imaging before hospital discharges. All patients with STEMI had low LV GLPSS (mean: −10.57<!--> <!-->±<!--> <!-->2.67%). Significant inverse correlation was observed between LV GLPSS and IS (<em>p</em> <!-->=<!--> <!-->0.03, <em>r</em> <!-->=<!--> <!-->0.39) with the cut-off point for GLPSS, which defined large myocardial infarction size (⩾30% of LV mass), was −11.5% with 93% sensitivity and 67% specificity (AUC<!--> <!-->=<!--> <!-->0.8). Also LV GLPSS proportionally correlated with EF (<em>p</em> <!-->=<!--> <!-->0.01, <em>r</em> <!-->=<!--> <!-->0.35) and inversely correlated with WMSI (<em>p</em> <!-->=<!--> <!-->0.04, <em>r</em> <!-->=<!--> <!-->0.5). WMSI showed the most significant correlation to IS (<em>p</em> <!-->=<!--> <!-->0.0, <em>r</em> <!-->=<!--> <!-->0.64). Significant correlation was observed between IS and EF (<em>p</em> <!-->=<!--> <!-->0.04, <em>r</em> <!-->=<!--> <!-->0.37). No significant correlation was found neither between ESVI and IS (<em>p</em> <!-->=<!--> <!-->0.4, <em>r</em> <!-->=<!--> <!-->0.2) nor GLPSS (<em>p</em> <!-->=<!--> <!-->0.08, <em>r</em> <!-->=<!--> <!-->0.33).</p></div><div><h3>Conclusions</h3><p>Assessment of IS by echocardiography after PCI in patients with STEMI was superior with GLS and WMSI when compared with LVEF and ESVI. Since global strain is an inexpensive test, these data may be of health economic interest.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"3 2","pages":"Pages 45-53"},"PeriodicalIF":0.3000,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2015.10.002","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2090730315000158","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 5
Abstract
Aim
Our objective was to assess the global longitudinal peak systolic strain (GLPSS) by speckle tracking echocardiography (STE) in patients with STEMI in the first 24 h after primary percutaneous coronary intervention (PCI) and its correlation with LV infarction size and ejection fraction.
Methods and results
A total of 30 patients with STEMI (mean age: 58 ± 8 years, 25 men) were studied. All patients underwent 1ry PCI. Conventional 2D echocardiography was performed to assess left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and end systolic volume index (ESVI), while STE was performed within 24 h of 1ry PCI to assess LV GLPSS. Infarction size was estimated by myocardial perfusion imaging before hospital discharges. All patients with STEMI had low LV GLPSS (mean: −10.57 ± 2.67%). Significant inverse correlation was observed between LV GLPSS and IS (p = 0.03, r = 0.39) with the cut-off point for GLPSS, which defined large myocardial infarction size (⩾30% of LV mass), was −11.5% with 93% sensitivity and 67% specificity (AUC = 0.8). Also LV GLPSS proportionally correlated with EF (p = 0.01, r = 0.35) and inversely correlated with WMSI (p = 0.04, r = 0.5). WMSI showed the most significant correlation to IS (p = 0.0, r = 0.64). Significant correlation was observed between IS and EF (p = 0.04, r = 0.37). No significant correlation was found neither between ESVI and IS (p = 0.4, r = 0.2) nor GLPSS (p = 0.08, r = 0.33).
Conclusions
Assessment of IS by echocardiography after PCI in patients with STEMI was superior with GLS and WMSI when compared with LVEF and ESVI. Since global strain is an inexpensive test, these data may be of health economic interest.
期刊介绍：
The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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