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Updated: Feb 25, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Early Speckle-tracking Echocardiography Predicts Left Ventricle Remodeling after Acute ST-segment Elevation
Donato Mele1, Marianna Nardozza1, Elisabetta Chiodi2
1Department of Emergency, Noninvasive Cardiology Unit, University Hospital of Ferrara, Ferrara, Italy.
Insights
Predicting left ventricular remodeling after ST-segment elevation myocardial infarction is challenging. Severe altered longitudinal strain area measured early by 2D-STE is a valuable predictor of remodeling after six months.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Predicting left ventricular remodeling (LVR) after ST-segment elevation myocardial infarction (STEMI) with effective reperfusion is difficult.
- Accurate prediction of LVR is crucial for guiding post-MI management.
Purpose of the Study:
- To evaluate the predictive value of echocardiographic parameters for LVR after STEMI.
- To identify early imaging markers that predict LVR.
Main Methods:
- Forty-one STEMI patients undergoing primary angioplasty were assessed.
- Echocardiography (including 2D-STE for LV ejection fraction, global longitudinal strain, and severe altered longitudinal strain area) and CMR were performed within 72 hours.
- LVR was defined as a >15% increase in LV end-diastolic volume after 6 months.
Main Results:
- Ten patients (24%) experienced LVR.
- Baseline severe altered longitudinal strain area showed a strong correlation with LVR (r=0.81).
- A severe altered longitudinal strain area ≥15% predicted LVR with 80% sensitivity and 90.3% specificity.
Conclusions:
- Severe altered longitudinal strain area assessed by 2D-STE early after STEMI is a valuable predictor of LVR at 6 months.
- Further research is needed to confirm its role in predicting patient survival.
Background:
Prediction of the left ventricular remodeling (LVR) after ST-segment elevation myocardial infarction (STEMI) in patients treated with effective myocardial reperfusion is challenging.
Methods:
Forty-one consecutive patients (36 males, age 59 ± 10 years) with STEMI who underwent effective (TIMI III) primary coronary angioplasty were enrolled. All patients had an echocardiography and cardiac magnetic resonance (CMR) study within 72 h from revascularization. Three echocardiographic parameters including LV ejection fraction (EF), global longitudinal strain (GLS) and severe altered longitudinal strain (SAS) area by two-dimensional speckle-tracking echocardiography (2D-STE) and 3 CMR indices including LV global function index (LV-GFI), myocardial salvage index (MSI), and microvascular obstruction (MVO) were calculated. LVR was defined as an increase in CMR LV end-diastolic volume (EDV) >15% after 6 months.
Results:
Of 41 patients, 10 (24%) had LVR (LV-EDV from 145.1 ± 29.3 to 185.9 ± 49.8 ml, P < 0.001). A significant correlation with LV-EDV variation was found for baseline SAS area (r = 0.81), LV-GFI (r = -0.56), MVO (r = 0.55), EF (r = -0.42), GLS (r = 0.42), not for MSI (r = -0.25). At the multivariable analysis, a significant correlation remained only for the SAS area. The receiver-operating characteristic curve analysis showed that a baseline SAS area ≥15% predicts LVR with a sensitivity of 80.0% and a specificity of 90.3%.
Conclusions:
The SAS area evaluated by 2D-STE early in acute STEMI is a valuable predictor of LVR after 6 months. Further investigations are needed to verify its value in predicting patient survival.
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