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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Strain echocardiography predicts acute coronary occlusion in patients with non-ST-segment elevation acute coronary

Christian Eek1, Bjørnar Grenne, Harald Brunvand

  • 1Department of Cardiology, Rikshospitalet, Oslo University Hospital and University of Oslo, 0027 Oslo, Norway.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|February 27, 2010
PubMed

Insights

Echocardiography can identify acute coronary occlusion in non-ST-elevation acute coronary syndrome (NSTE-ACS) patients. Strain echocardiography accurately detects myocardial dysfunction, aiding in timely reperfusion therapy decisions.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Electrocardiogram (ECG) may not show typical myocardial infarction signs in acute coronary occlusion.
  • Non-ST-elevation acute coronary syndrome (NSTE-ACS) requires accurate diagnosis of coronary occlusion.
  • Echocardiography offers a non-invasive method to assess myocardial function.

Purpose of the Study:

  • To evaluate echocardiographic modalities for identifying coronary occlusion in NSTE-ACS patients.
  • To quantify myocardial dysfunction using echocardiography in the presence of coronary occlusion.
  • To compare strain echocardiography and wall motion scoring for detecting coronary occlusion.

Main Methods:

  • 150 NSTE-ACS patients underwent echocardiography before coronary angiography.
  • Left ventricular ejection fraction and regional myocardial function (longitudinal strain, wall motion score) were assessed.
  • Speckle tracking echocardiography measured longitudinal strain in a 16-segment model.

Main Results:

  • 22% of patients had acute coronary occlusion, with reduced ejection fraction.
  • Patients with occlusion showed significantly more dysfunctional myocardial segments (median 7 vs. 2).
  • Strain echocardiography identified >or=4 adjacent dysfunctional segments with 85% sensitivity and 70% specificity for occlusion.

Conclusions:

  • Strain echocardiography is effective in identifying NSTE-ACS patients with acute coronary occlusion.
  • Early detection of coronary occlusion via strain echocardiography can guide urgent reperfusion therapy.
  • Echocardiography provides valuable functional information when ECG findings are atypical.
Abstract

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