부산대학교 도서관

Objective: To evaluate whether circumferential and radial strain can identify changes in segmental kinetics in patients with acute myocardial infarction with ST elevation (AMI).Methodology: An echocardiogram (Vivid 7, GE) was performed during the first 72h of admission in consecutive patients (pts) with AMI that underwent primary angioplasty. Wall motion score (WMS) was evaluated by two independent observers and established by consensus. Myocardial deformation was assessed in post-processing using the peak systolic circumferential strain (PSSC) and the peak radial strain (PMSR). Deformation parameters were compared according to the WMS and the ventricular level by ANOVA and their association was evaluated by the correlation coefficient Kendallʼs Tau b. The accuracy in detecting abnormality of segmental kinetics (WMS ≥ 2) was determined by area under the Receiver Operator Curve (AUC).Results: 176 patients were studied (male: 70%, 63 ± 14 years). The artery responsible for AMI was anterior descending in 43%, circumflex in 17% and right coronary in 39%. The quality of image was adequate to the study by speckle-tracking in 1200 segments. The PSSC was more negative in the normal segments (p = 0.001), while the PMSR decreased progressively with the WMS (p <0.001). Among the hypokinetic normokinetic segments, the PSSC varied with ventricular plan, being more negative in the apical segments (p <0.001). Therefore, correlations with WMS and PSSC increased from the basal plane (k = 0.312) for the medium (k = 0.384) and to the apical level (k = 0.442), p <0.001. PSSCʼs overall acuity to detect abnormality of segmental kinetics (ROC: 0.747) was superior to PMSR (ROC: 0.66).Conclusion: Radial and circumferential strain parameters allows the objective quantification of the segmental kineticʼs in patients with AMI.