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Published on: June 28, 2019
Relationship between strain rate imaging and coronary flow reserve in assessing myocardial viability after acute
Seong-Mi Park1, Soon-Jun Hong, Jae-Suk Park
1Division of Cardiology, Korea University College of Medicine, Seoul, Republic of Korea.
Insights
Strain rate (SR) imaging can noninvasively assess myocardial viability after acute myocardial infarction (MI). This method correlates with coronary flow reserve (CFR), offering a promising tool for predicting heart tissue recovery post-MI.
Area of Science:
- Cardiology
- Medical Imaging
- Myocardial Infarction Research
Background:
- Assessing myocardial viability after acute myocardial infarction (MI) is crucial for guiding treatment and predicting outcomes.
- Traditional methods for evaluating myocardial viability can be invasive or limited in their ability to predict functional recovery.
Purpose of the Study:
- To investigate the relationship between strain rate (SR) imaging and coronary flow reserve (CFR) in determining the viability of akinetic myocardium post-MI.
- To assess the potential of SR imaging as a noninvasive tool for predicting myocardial viability.
Main Methods:
- The study included 40 patients who experienced an acute ST-elevation MI.
- SR imaging and intracoronary flow measurements for CFR were performed 3-5 days post-intervention.
- Myocardial viability was assessed using echocardiography at 6 weeks.
Main Results:
- Viable akinetic myocardium showed significantly greater systolic SR, early diastolic SR, and systolic strain compared to nonviable myocardium.
- Coronary flow reserve (CFR) was significantly higher in patients with viable akinetic myocardium.
- Early diastolic SR demonstrated the strongest correlation with CFR (P < 0.001), with high sensitivity (90.5%) and specificity (57.9%) for predicting viability.
Conclusions:
- Myocardial deformation assessed by SR imaging is closely related to microvascular integrity indicated by CFR.
- SR imaging serves as a valuable noninvasive method for predicting myocardial viability following acute MI.
- SR imaging parameters, particularly early diastolic SR, show strong potential in identifying viable myocardium post-MI.
Objectives:
To evaluate the relationship between strain rate (SR) imaging and coronary flow reserve (CFR) in assessing viability of akinetic myocardium after acute myocardial infarction (MI).
Methods:
Forty patients with acute first ST-elevation MI were analyzed. SR imaging and CFR by intracoronary flow measurement were obtained on the same day, 3~5 days after primary percutaneous coronary intervention. Viability of the akinetic myocardium was determined on 6-week echocardiography.
Results:
Systolic SR (SRs, -0.42 ± 0.10 vs. -0.35 ± 0.11 per second, P = 0.03), early diastolic SR (SRe, 0.68 ± 0.31 vs. 0.41 ± 0.22 per second, P = 0.003), and systolic strain (Ss, -5.9 ± 3.4 vs. -2.5 ± 4.0%, P = 0.04) were greater in akinetic, but viable myocardium of 21 patients than in akinetic and nonviable myocardium of 19 patients. CFR was also higher in patients with akinetic, but viable myocardium (2.0 ± 0.5 vs. 1.5 ± 0.5, P < 0.001). SRs, SRe, and Ss were significantly related to CFR (r =-0.50, r = 0.58, r =-0.56, respectively, all P ≤ 0.001) and SRe was most related to CFR (P < 0.001). The sensitivity and specificity to predict myocardial viability were 85.7% and 68.4% for CFR (cutoff = 1.75), and 90.5% and 57.9% for SRe (cutoff = 0.37 per second), respectively.
Conclusions:
The degree of myocardial deformation determined by SR imaging was related to the degree of microvascular integrity determined by CFR, and can be used as a noninvasive method to predict myocardial viability after acute MI.
