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Strain echocardiography and wall motion score index predicts final infarct size in patients with

Christian Eek1, Bjørnar Grenne, Harald Brunvand

  • 1Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway.

Circulation. Cardiovascular Imaging
|January 16, 2010
PubMed

Insights

Echocardiography before revascularization can predict final infarct size in non-ST-elevation myocardial infarction. Wall motion score index and global longitudinal strain effectively identify substantial myocardial infarction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiovascular Research

Background:

  • Infarct size is a critical predictor of mortality and adverse events post-myocardial infarction.
  • Acute reperfusion therapy improves survival but is typically limited to ST-segment-elevation myocardial infarction.
  • Identifying patients with non-ST-segment-elevation myocardial infarction (NSTEMI) who have substantial infarction is crucial.

Purpose of the Study:

  • To evaluate the relationship between echocardiographic left ventricular (LV) systolic function parameters and final infarct size in NSTEMI patients before revascularization.
  • To determine the ability of these echocardiographic parameters to identify patients with significant myocardial infarction.

Main Methods:

  • Echocardiography was performed on 61 NSTEMI patients before revascularization.
  • LV systolic function was assessed using ejection fraction, wall motion score index, and global strain (circumferential, longitudinal, radial).
  • Infarct size was measured by late-enhancement MRI after 9 months.

Main Results:

  • A strong correlation was observed between infarct size and wall motion score index (r=0.74) and global longitudinal strain (r=0.68).
  • Global longitudinal strain >-13.8% and wall motion score index >1.30 accurately identified substantial infarction (≥12% of LV myocardium).
  • Area under the receiver operator curve was 0.95 for GLS and 0.92 for WMIS.

Conclusions:

  • Echocardiographic LV systolic function parameters correlate with infarct size in NSTEMI.
  • Global longitudinal strain and wall motion score index are effective in identifying substantial myocardial infarction.
  • These parameters can help identify NSTEMI patients who may benefit from urgent reperfusion therapy.
Abstract

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