[Layer-specific Analysis in Patients with ST Segment Elevation Myocardial Infarction]
He Huang1, Xiao-Qin Liu1, Bao-Tao Huang1
1Department of Cardiology, West China Hospital, Sichuan University,Chengdu 610041,China.
Insights
Layer-specific analysis of left ventricular function after ST-segment elevation myocardial infarction (STEMI) reveals that longitudinal epicardial strain predicts left ventricular remodeling (LVR). This finding aids in assessing cardiac function post-STEMI.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- ST-segment elevation myocardial infarction (STEMI) can lead to adverse left ventricular remodeling (LVR).
- Assessing regional myocardial function is crucial for predicting LVR after STEMI.
- Layer-specific analysis offers a more detailed evaluation of ventricular wall mechanics.
Purpose of the Study:
- To evaluate left ventricular (LV) wall function using layer-specific analysis after STEMI.
- To determine if layer-specific parameters can predict LVR.
- To investigate changes in myocardial strain in STEMI patients.
Main Methods:
- Studied 39 patients with first STEMI post-primary percutaneous coronary intervention (P-PCI) and 30 healthy controls.
- Performed echocardiography within 48 hours and 6 months after P-PCI.
- Analyzed 3D cardiac function and longitudinal/circumferential 3-layer strain.
Main Results:
- Circumferential strain decreased from endocardium to epicardium in STEMI patients.
- Longitudinal and circumferential 3-layer strain improved at 6 months but remained lower than in controls.
- Lower longitudinal and circumferential 3-layer strain were observed in the LVR group.
- Longitudinal epicardial strain independently predicted LVR (OR: 3.332, P=0.03).
Conclusions:
- Myocardial strain distribution varies by layer in STEMI patients within 48 hours post-P-PCI.
- Reduced myocardial function is associated with LVR.
- Longitudinal epicardial strain is a significant predictor of LVR after STEMI.
Objectives:
To evaluate left ventricular wall function after ST segment elevation myocardial infarction(STEMI) by layer-specific analysis and determine if the layer-specific parameters can predict left ventricular remodeling(LVR).
Methods:
Thirty nine patients with first STEMI who had successful primary percutaneous coronary intervention(P-PCI) were studied, while 30 healthy individuals were included as normal control. Echocardiographic examinations were performed in STEMI patients within 48 h after P-PCI (before follow-up) and 6 months later (follow-up). Three dimensional cardiac function and longitudinal, circumferential 3-layer strain were analyzed.
Results:
In STEMI, longitudinal endocardial strain was higher than epicardial strain (P<0.01), circumferential strain decreased from endocardium to epicardium gradually (P<0.01). Longitudinal and circumferential 3-layer strain at follow-up was higher than that before follow-up (P<0.01), but lower than that in control group( P<0.05). LVR group had lower longitudinal and circumferential 3-layer strain (P<0.05). Longitudinal epicardial strain was the independent predictor of LVR(odds ratio:3.332,95% confidence interval:1.124-3.882,P=0.03), the cut off value of -9% yielded 89.5% sensitivity and 70.2% specificity.
Conclusions:
Strain decreased from endocardium to epicardium within 48 h after P-PCI in STEMI. Myocardial function was lower in LVR group. Longitudinal epicardial strain could be employed as an independent predictor of LVR after STEMI.
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