Changes in three-dimensional speckle-tracking-derived myocardial strain during percutaneous coronary intervention

Area of Science:

• Cardiology
• Echocardiography
• Medical Imaging

Background:

• Myocardial ischemia, often caused by coronary artery disease, can lead to impaired heart function.
• Early detection of ischemia is crucial for timely intervention and improved patient outcomes.
• Traditional methods may not detect functional changes until significant damage has occurred.

Purpose of the Study:

• To evaluate changes in three-dimensional (3D) speckle-tracking-derived myocardial strain during ischemic events.
• To compare the sensitivity of 3D and 2D speckle-tracking echocardiography in detecting ischemia-induced myocardial deformation.
• To determine if 3D strain analysis can identify functional changes before visible wall motion abnormalities.

Main Methods:

• Twenty patients undergoing percutaneous coronary intervention (PCI) for coronary artery stenosis were studied.
• Three-dimensional (3D) and two-dimensional (2D) echocardiography were used to record myocardial strain during coronary occlusion.
• Ultrasound contrast agent delineated ischemic and peri-ischemic segments post-PCI for comparative analysis.

Main Results:

• Despite preserved wall motion and ejection fraction, 2D global longitudinal strain decreased during PCI (P=.01).
• All 3D strain components (longitudinal, circumferential, area, radial) showed significant impairment during ischemia (P<.05).
• 3D strain analysis identified functional changes in ischemic and peri-ischemic segments prior to wall motion abnormalities.

Conclusions:

• Three-dimensional (3D) speckle-tracking echocardiography can characterize myocardial deformation during ischemia.
• This technique detects functional changes before the onset of wall motion abnormalities.
• 3D strain analysis represents a promising tool for early ischemia detection.