Longitudinal strain provides prognositic value, incremental to that of cardiac magnetic resonance at the acute phase in patients with st-segment elevation myocardial infarction - Université de Rennes Accéder directement au contenu
Communication Dans Un Congrès European Heart Journal Année : 2013

Longitudinal strain provides prognositic value, incremental to that of cardiac magnetic resonance at the acute phase in patients with st-segment elevation myocardial infarction

Résumé

Objectives: We assessed the value of speckle tracking imaging performed early after a first ST-segment elevation myocardial infarction (STEMI) in order to predict infarct size and functional recovery at 3-month follow-up. Methods: Forty-four patients with STEMI who underwent revascularization within 12 h of symptom onset were prospectively enrolled. Echocardiography was performed 3.9±1.2 days after myocardial reperfusion, assessing circumferential (CGS), radial (RGS), and longitudinal global (GLS) strains. Late gadolinium-enhanced cardiac magnetic imaging (CMR), for assessing cardiac function, infarct size, and microvascular obstruction (MVO), was conducted 5.6±2.5 days and 99.4±4.6 days after myocardial reperfusion. Results: GLS was evaluable in 97% of the patients, while CGS and RGS could be assessed in 85%. Infarct size significantly correlated with GLS (R=0.601, p<0.001), RGS (R=-0.405, p=0.010), CGS (R=0.526, p=0.001), ejection fraction (R=-0.699, p<0.001), wall motion score index (R=0.539, p=0.001), and left atrial volume (R=0.510, p<0.001). Baseline ejection fraction and GLS were independent predictors of 3-month infarct size. MVO mass significantly correlated with GLS (R=0.391, p=0.010), RGS (R=-0.259, p=0.066), wall motion score index (R=0.387, p=0.011), and ejection fraction (R=-0.389, p=0.011). In multivariate analysis, GLS was the only independent predictor of MVO mass (p=0.02). Longitudinal strain >-6.0% within the infarcted area exhibited 96% specificity and 61% sensitivity for predicting the persistence of akinesia (≥3 segments) at 3-month follow-up. Conclusions: Speckle-tracking strain imaging performed early after a STEMI is an easy-to-use tool for predicting persistent akinetic territories at 3 months. In addition, GLS correlated significantly with MVO and final infarct size, both parameters being relevant post-MI prognostic factors, usually obtained via CMR.
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Dates et versions

hal-00934736 , version 1 (22-01-2014)

Identifiants

  • HAL Id : hal-00934736 , version 1

Citer

L. Biere, Erwan Donal, G. Terrien, Gaëlle Kervio, Alain Furber, et al.. Longitudinal strain provides prognositic value, incremental to that of cardiac magnetic resonance at the acute phase in patients with st-segment elevation myocardial infarction. Congress of the European-Society-of-Cardiology (ESC), Aug 2013, Amsterdam, Netherlands. pp.83-83. ⟨hal-00934736⟩
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