Number of segments with motion abnormalities is better correlated with infarct size in acute myocardial infarction

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• The correlation between speckle-tracking echocardiography (STE) motion abnormalities and myocardial infarct size (MIS) determined by cardiac MRI is not well-established.
• Accurate assessment of MIS is crucial for managing patients with acute myocardial infarction (MI).

Purpose of the Study:

• To investigate the relationship between the number of segments with motion abnormalities (SMA) identified via STE and the myocardial infarct size (MIS) measured by late gadolinium-enhanced cardiac MRI (LGE-cMRI).
• To determine if SMA can serve as a reliable indicator of MIS in patients with acute MI.

Main Methods:

• Left ventricular two-dimensional STE and LGE-cMRI were performed in 380 patients with ST-segment elevation MI (STEMI).
• Patients underwent imaging within 48 hours and 5-6 days after primary percutaneous intervention, respectively.
• Statistical analyses, including multivariate logistic regression and ROC curve analysis, were used to assess the predictive value of SMA for large MIS.

Main Results:

• A greater number of SMA correlated significantly with larger infarct sizes (P < 0.05).
• The total number of SMA (OR=1.976) and the number of segments with paradoxical systolic movements (SPSM) (OR=3.703) were independent predictors of large MIS (>19%).
• The area under the ROC curve for total SMA (0.904) was superior to global longitudinal strain (GLS, 0.813), global work efficiency (GWE, 0.794), and SPSM (0.851) for predicting large MIS. An optimal cutoff of 7 SMA segments demonstrated 85.31% sensitivity and 81.48% specificity.

Conclusions:

• The total number of SMA is strongly associated with myocardial infarct size.
• SMA provides incremental prognostic value beyond established parameters like GLS and GWE.
• STE-derived SMA is a valuable tool for estimating infarct size in acute MI patients.