Value of three dimensional-speckle tracking imaging for predicting left ventricular function after non-ST-segment elevation myocardial infarction with percutaneous coronary intervention
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Published on: May 28, 2019
Yongjuan Luo1, Yujie Liu2, Xin Guan1
1Department of Ultrasound, Tianjin Chest Hospital, China.
Insights
Three-dimensional speckle tracking imaging (3D-STI) effectively assesses cardiac function in non-ST-segment elevation myocardial infarction (NSTEMI) patients post-percutaneous coronary intervention (PCI). Combined with NT-pro BNP, it offers an efficient method for evaluating heart function recovery.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Percutaneous coronary intervention (PCI) is the standard treatment for high-risk patients with non-ST-segment elevation myocardial infarction (NSTEMI).
- Assessing cardiac function post-PCI is crucial for patient outcomes.
- Traditional methods may not fully capture subtle changes in myocardial mechanics.
Purpose of the Study:
- To evaluate the application of three-dimensional speckle tracking imaging (3D-STI) in NSTEMI patients undergoing PCI.
- To assess changes in left ventricular (LV) strain and torsion after PCI.
- To correlate imaging parameters with cardiac biomarkers.
Main Methods:
- Forty-four NSTEMI patients and 20 healthy controls were studied.
- NSTEMI patients were categorized into heart failure with normal (HF-NEF), preserved (HF-PEF), and reduced (HF-REF) ejection fraction groups.
- 3D-STI measured global longitudinal (GLS), circumferential (GCS), radial (GRS) strain, and LV torsion pre-PCI and at 1 and 3 months post-PCI. Biomarkers (hs-TNT, hs-CRP, NT-pro BNP) were also measured.
Main Results:
- NSTEMI patients showed significantly decreased GLS, GCS, and torsion compared to controls.
- GLS and torsion improved significantly at 1 and 3 months post-PCI in all NSTEMI groups.
- Elevated hs-TNT, hs-CRP, and NT-pro BNP pre-PCI decreased post-PCI. LVEF correlated positively with LVESV and torsion, and negatively with GLS, GCS, and NT-pro BNP.
Conclusions:
- 3D-STI effectively detects impaired myocardial mechanics in NSTEMI patients.
- LV strain and torsion show significant recovery after PCI.
- Combining 3D-STI with NT-pro BNP provides an efficient assessment of cardiac function in NSTEMI patients post-PCI.
Background:
Percutaneous coronary intervention (PCI) is the recommended treatment for high risk patients with non-ST-segment elevation myocardial infarction (NSTEMI).
Objective:
To investigate the application of three dimensional-speckle tracking imaging (3D-STI) on patients diagnosed with NSTEMI undergoing PCI.
Methods:
Forty-four NSTEMI patients and 20 healthy subjects that received basic clinical and laboratory examinations were included in our study. NSTEMI patients were divided into three groups: heart failure (HF) with normal ejection fraction (HF-NEF group, n = 19), heart failure with preserved ejection fraction (HF-PEF group, n = 14) and heart failure with a reduced ejection fraction (HF-REF group, n = 11). The global longitudinal peak systolic strain (GLS), global circumferential peak systolic strain (GCS), global radial peak systolic strain (GRS) and left ventricular (LV) torsion of all subjects were measured by 3D-STI before PCI and 1 month, 3 months after PCI. The high-sensitivity troponin T (hs-TNT), high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-pro BNP) were measured in each group. Correlations between these parameters and LV ejection fraction (LVEF) were tested by Pearson correlation analysis.
Results:
GLS, GCS and torsion were significantly decreased in the 3 NSTEMI groups compared with control group (P < 0.05). GLS, torsion were significantly improved in the three NSTEMI groups at postoperative 1 and 3 months (P < 0.05). HF-REF group showed improved GCS on postoperative 1 and 3 month compared with preoperative data, and improved GLS at 3-month follow-up compared with 1-month follow-up (P < 0.05). The hs-TNT, hs-CRP and NT-pro BNP increased in the three NSTEMI groups before PCI (P < 0.05), and decreased at postoperative 1 and 3 month (P < 0.05). LVEF has the positive correlations with LV endsystolic volume (LVESV) and torsion, as well as the negative correlations with LVGLS, LVGCS, NT-pro BNP (P < 0.05).
Conclusions:
The combinative detection of 3D-STI and NT-pro BNP is an efficient way to assess the cardiac function in patients diagnosed with NSTEMI undergoing PCI.
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