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. 2010 Sep;25(3):260-8.
doi: 10.3904/kjim.2010.25.3.260. Epub 2010 Aug 31.

Usefulness of peak systolic strain measurement by automated function imaging in the prediction of coronary perfusion in patients with acute myocardial infarction

Jung Sun Cho  1 , Kye Hun Kim, Woo Seok Lee, Hyun Ju Yoon, Nam Sik Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Affiliations

Usefulness of peak systolic strain measurement by automated function imaging in the prediction of coronary perfusion in patients with acute myocardial infarction

Jung Sun Cho et al. Korean J Intern Med. 2010 Sep.

Abstract

Background/aims: The usefulness of global longitudinal peak systolic strain (GLPSS) measurement by automated function imaging (AFI) in the prediction of perfusion status of infarct-related artery (IRA) before percutaneous coronary intervention (PCI) was evaluated.

Methods: Sixty-nine patients with acute myocardial infarction (AMI) who underwent successful primary PCI were divided into two groups; the patients with occlusion of IRA (Group I, 41 patients, 63.0 ± 14.9 years of age, 31 males) versus the patients with patent IRA (Group II, 28 patients, 63.8 ± 11.2 years of age, 15 males). GLPSS by AFI and wall-motion score index (WMSI) were analyzed in both groups.

Results: GLPSS was significantly decreased in Group I compared with Group II (-11.2 ± 3.7 vs. -14.1 ± 4.7%, p = 0.005), but WMSI (1.49 ± 0.28 vs. 1.35 ± 0.32, p = 0.062) did not differ between groups. GLPSS of infarct segments was significantly lower (-3.7 ± 5.4 vs. -11.4 ± 4.8%, p < 0.001), and WMSI of infarct segments was significantly higher (2.13 ± 0.57 vs. 1.66 ± 0.57, p = 0.001) in Group I compared with Group II. By receiver operation curve analysis, the area under the curve to predict IRA occlusion was 0.850 in GLPSS of infarct segments and 0.719 in WMSI of infarct segments. The optimal cut-off value to predict IRA occlusion was -9.4% in GLPSS of infarct segments (sensitivity, 85.4%; specificity, 67.9%) and 1.68 in WMSI of infarct segments (sensitivity, 78.0%; specificity, 60.7%).

Conclusions: The present study suggested that GLPSS measured by AFI is a more sensitive predictor of IRA occlusion than is WMSI before PCI. Routine measurement of GLPSS by AFI can be a very useful tool in risk stratification of AMI.

Keywords: Myocardial infarction; Myocardial reperfusion; Strain.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Representative example of the measurement of peak systolic strain by automated function image in a patient with an acute anterior wall myocardial infarction caused by the total occlusion of the mid-portion of the left anterior descending coronary artery. Peak systolic strain of anferior and septal wall was decreased in 4-chamber (A), 3-chamber (B), and 2-chamber (C). The decreasema of peak systolic strain of left anterin descending coronary antery territory was shown on Bull's eye view (D). ANT, anterior; LAT, lateral; POST, posterior; INF, inferior; SEPT, septal.
Figure 2
Figure 2
Wall-motion score index (A) and peak systolic strain (B) of the left ventricular segments supplied by the infarct-related artery between the groups. IRA, infarct-related artery; WMSI, wall-motion score index; PSS, peak systolic strain.
Figure 3
Figure 3
Receiver operation characteristic curves of the peak systolic strain (solid line) and wall-motion score index (dotted line) of the infarcted segment of the left ventricle. The asterisk indicates the optimal cut-off points to predict the occlusion of the infarct-related artery.
See this image and copyright information in PMC

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