Can changes in systolic longitudinal deformation quantify regional myocardial function after an acute infarction? An ultrasonic strain rate and strain study
Can changes in systolic longitudinal deformation quantify regional myocardial function after an acute infarction? An ultrasonic strain rate and strain study
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DOI：
10.1067/mje.2002.118913
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发表时间：
2002-07-01
影响因子：
6.5
通讯作者：
Derumeaux, G
中科院分区：
文献类型：
--
作者：
Jamal, F;Kukulski, T;Derumeaux, G
目的：本研究的目的是评估超声应变率和应变对心肌速度的附加价值，以识别和量化急性心肌梗死（MI）后的区域性不同步。四十名患者在首次梗死后3 +/-2天，对59 +/-13岁的患者进行了研究，并与14名年龄匹配的正常收缩节段的对照组进行了比较A组146例。纵向心肌速度，应变率（SR）和应变（SR）后处理的基底，中间，和心尖段询问使用心尖视图。在冠状动脉造影的患者子集（n = 24）中，将心肌节段分为3组：正常收缩的正常冠状动脉供血节段（B1组），正常收缩的病变冠状动脉供血节段（B2组），以及运动异常的节段（B3组）。心肌梗死（MI）患者的速度降低（与对照组相比P <0.05），但无法准确区分正常收缩段与异常收缩段。在对侧，收缩期SR和E：随节段性失能的严重程度而显著降低，并可识别梗死相关节段（B3组），其敏感性/特异性为85%（收缩期SR和E截止值分别为-0.8s（-1）和-13%，D_1）。
Objectives: The aim of this study was to evaluate the additional value of ultrasonic strain rate and strain to myocardial velocity in the identification and quantification of regional asynergy after an acute myocardial infarction (MI).Methods: Forty patients (59 +/- 13 years) were investigated 3 +/- 2 days after a first infarction and compared with 14 age-matched controls with normally contracting segments (group A, n = 146). Longitudinal myocardial velocities, strain rate (SR) and strain (epsilon) were postprocessed from basal, mid, and apical segments interrogated using apical views. In a subset of patients with coronary angiograms (n = 24), myocardial segments were divided into 3 groups: normally contracting segments supplied by a normal coronary artery (group B1), normally contracting segments supplied by a diseased coronary artery (group B2), and segments with abnormal motion (group B3). Velocities were decreased in patients with myocardial infarction (MI) (P < .05 vs controls) but failed to accurately differentiate normally from abnormally contracting segments. At the opposite end, systolic SR and E: decreased significantly with segmental asynergy severity and could identify infarct-involved segments (group B3) with a sensitivity/specificity of 85% (systolic SR and E cutoff values of -0.8 s(-1) and -13%, respectively).Conclusion: Strain rate and strain can better assess segmental dysfunction severity than myocardial velocities alone after an acute MI.