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Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients After Myocardial Infarction

Received: 26 March 2020    Accepted: 10 April 2020    Published: 30 April 2020
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Abstract

Background: Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy, and deteriorating function, which if uninterrupted leads to congestive heart failure (CHF) and a poor clinical outcome, begins in some patients with acute myocardial infarction (AMI) even after successful percutaneous coronary intervention (PCI). Aims: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four acute myocardial infarction patients. A thorough physical examination, electrocardiography (ECG) and a complete echocardiographic assessment, including speckle tracking study, was performed two days after PCI and then a follow up echocardiography with speckle tracking study was done two months afterwards. Patients were then divided into two groups based on the presence of remodelling (R+, R-). RESULTS: at baseline study global longitudinal strain (GLS) (-11.14±0.5 VS -16.78±0.4, P<0.0001), longitudinal strain rate (LSr) (-1.01±0.05 VS -1.07±0.04, P<0.0001), culprit longitudinal strain (CulLS) (-9.74±0.59 VS -15.68±0.49, P<0.0001), culprit longitudinal strain rate (CulLSr) (-0.95±0.05 VS -1.02±0.04, P<0.0001) were all lower in group R+ than in R-. In the follow up study, all strain parameters studied were significantly lower in the R+ group than R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively) and (specificities of 95% and 96.7% respectively). CONCLUSION: Our findings show that impaired indices LV deformation detected two days after successful PCI for AMI may provide predictive value in detecting LV remodelling.

Published in Cardiology and Cardiovascular Research (Volume 4, Issue 2)
DOI 10.11648/j.ccr.20200402.15
Page(s) 59-66
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Left Ventricular Remodelling, Acute Myocardial Infarction, Speckle Tracking Echocardiography

References
[1] Abate E, Hoogslag GE, Leong DP, et al. 2014: Association between multilayer left ventricular rotational mechanics and the development of left ventricular remodeling after acute myocardial infarction. J Am Soc Echocardiogr. Mar; 27 (3): 239–48.
[2] Aikawa Y, Rohde L, Plehn J, et al. (2001) Regional wall stress predicts ventricular remodeling after anteroseptal myocardial infarction in the Healing and Early Afterload Reducing Trial (HEART): an echocardiography-based structural analysis. Am Heart J. 141: 234-242.
[3] Arnold SV, Spertus JA, Masoudi FA, et al. (2013): Beyond medication prescription as performance measures: optimal secondary prevention medication dosing after acute myocardial infarction, J Am Coll Cardiol 62: 1791–1801.
[4] Bertini M, Mollema SA, Delgado V, et al 2009: Impact of time to reperfusion after acute myocardial infarction on myocardial damage assessed by left ventricular longitudinal strain. Am J Cardiol; 104: 480-5.
[5] Bolognese L, Neskovic A, Parodi G (2002): Left ventricular remodeling after primary coronary angioplasty. Circulation; 106: 2351-7.
[6] Bonios MJ, Kaladaridou A, Tasoulis A, et al (2014): Value of apical circumferential strain in the early post-myocardial infarction period for prediction of left ventricular remodeling. Hellenic J Cardiol. Jul Aug; 55 (4): 305-12.
[7] Cerisano G, Bolognese L, Carrabba N, et al (1999). Doppler-derived mitral deceleration time. An early strong predictor of left ventricular remodeling after reperfused anterior acute myocardial infarction. Circulation; 99: 230-6.
[8] Eek C, Grenne B, Brunvand H, et al 2010: Strain echocardiography and wall motion score index predicts final infarct size in patients with non-ST-segment-elevation myocardial infarction. Circ Cardiovasc Imaging. Mar; 3 (2): 187-94.
[9] Farah E, Cogni AL, Minicucci MF, et al. (2012): Prevalence and predictors of ventricular remodeling after anterior myocardial infarction in the era of modern medical therapy. Med Sci Monit; 18 (5): CR276-81.
[10] Funaro S, Galiuto L, Boccalini F, et al. (2011): Determinants of microvascular damage recovery after acute myocardial infarction: Results from the Acute Myocardial Infarction Contrast Imaging (AMICI) multi-centre study, Eur J Echocardiogr 12 (4): 306–312.
[11] Gaudron P, Eilles C, Kugler I, et al. 1993 Progressive left ventricular dysfunction and remodeling after myocardial infarction: potential mechanisms and early predictors. Circulation; 87: 755–763.
[12] Gjesdal O, Helle-Valle T, Hopp E, et al. (2008): Noninvasive separation of large, medium, and small myocardial infarcts in survivors of reperfused ST-elevation myocardial infarction: a comprehensive tissue Doppler and speckle-tracking echocardiography study. Circ Cardiovasc Imaging. Nov; 1 (3): 189–96.
[13] Grabka M, Wita K, Tabor Z, et al. (2013): Prediction of infarct size by speckle tracking echocardiography in patients with anterior myocardial infarction. Coron Artery Dis. 2013 Mar; 24 (2): 127–34.
[14] Hsiao J-F, Chung C-M, Chu C-M, et al. (2016) Two-Dimensional Speckle Tracking Echocardiography Predict Left Ventricular Remodeling after Acute Myocardial Infarction in Patients with Preserved Ejection Fraction. PLoS ONE 11 (12): e0168109. doi: 10.1371/journal. pone.0168109.
[15] Huttin O, Coiro S, Selton-Suty C, et al. (2016) Prediction of Left Ventricular Remodeling after a Myocardial Infarction: Role of Myocardial Deformation: A Systematic Review and Meta Analysis. PLoS ONE 11 (12): e0168349. doi: 10.1371/journal. pone.0168349.
[16] Ingul CB, Malm S, Refsdal E, et al. 2010: Recovery of function after acute myocardial infarction evaluated by tissue Doppler strain and strain rate. J Am Soc Echocardiogr. Apr; 23 (4): 432–8.
[17] Joyce E, Hoogslag GE, Leong DP, et al. (2014): Association between left ventricular global longitudinal strain and adverse left ventricular dilatation after ST-segment-elevation myocardial infarction. Circ Cardiovasc Imaging. Jan; 7 (1): 74-81.
[18] Lacalzada J, de la Rosa A, Izquierdo MM, et al. (2015): Left ventricular global longitudinal systolic strain predicts adverse remodeling and subsequent cardiac events in patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Int J Cardiovasc Imaging; 31: 575-84.
[19] Liszka J, Haberka M, Tabor Z, et al. (2013): Two dimensional speckle tracking echocardiography assessment of left ventricular remodeling in patients after myocardial infarction and primary reperfusion. Arch Med Sci 6 (10): 1091-1100.
[20] Loboz-Grudzien k, Kowalska A, Brzezinska B, et al 2007: Early predictors of adverse left ventricular remodelling after myocardial infarction treated by primary angioplasty. Cardiol J; 14 (3): 238-45.
[21] Marwick TH, Leano RL, Brown J, et al. (2009) Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography: definition of normal range. JACC Cardiovasc Imaging. 2 (1): 80–4.
[22] Na HM, Cho GY, Lee JM, et al. 2016: Echocardiographic Predictors for Left Ventricular Remodeling after Acute ST Elevation Myocardial Infarction with Low Risk Group: Speckle Tracking Analysis. J Cardiovasc Ultrasound. Jun; 24 (2): 128-34.
[23] Nicolosi GL, Golcea S, Ceconi C 2009: Effects of perindopril on cardiac remodeling and prognostic value of pre-discharge quantitative echocardiographic parameters in elderly patients after acute myocardial infarction: the PREAMI echo substudy. Eur Heart J; 30: 1656-65.
[24] Pipilis A, Meyer TE, Ormerod D, et al. 1992. Early and late changes in left ventricular filling after acute myocardial infarction and the effect of infarct size. Am J Cardiol.; 70: 1397–1401.
[25] Popovic AD, Neskovic AN, Marinkovic J, et al 1996: Serial assessment of left ventricular chamber stiffness after acute myocardial infarction. Am J Cardiol.; 77: 361–364.
[26] Seropian IM, Sonnino C, Van Tassell BW, et al. (2015): Inflammatory markers in ST-elevation acute myocardial infarction, Eur Heart J Acute Cardiovasc Care.
[27] Takemura G, Nakagawa M, Kanamori H, et al. (2009): Benefits of reperfusion beyond infarct size limitation. Cardiovasc Res. 2009 Jul 15; 83 (2): 269-76.
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    Moustafa Kamal Eldin Ibrahim, Khalied Ahmad Emam El-khashab, Tamer Mosaad Elsaed Ragab. (2020). Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients After Myocardial Infarction. Cardiology and Cardiovascular Research, 4(2), 59-66. https://doi.org/10.11648/j.ccr.20200402.15

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    ACS Style

    Moustafa Kamal Eldin Ibrahim; Khalied Ahmad Emam El-khashab; Tamer Mosaad Elsaed Ragab. Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients After Myocardial Infarction. Cardiol. Cardiovasc. Res. 2020, 4(2), 59-66. doi: 10.11648/j.ccr.20200402.15

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    AMA Style

    Moustafa Kamal Eldin Ibrahim, Khalied Ahmad Emam El-khashab, Tamer Mosaad Elsaed Ragab. Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients After Myocardial Infarction. Cardiol Cardiovasc Res. 2020;4(2):59-66. doi: 10.11648/j.ccr.20200402.15

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  • @article{10.11648/j.ccr.20200402.15,
      author = {Moustafa Kamal Eldin Ibrahim and Khalied Ahmad Emam El-khashab and Tamer Mosaad Elsaed Ragab},
      title = {Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients After Myocardial Infarction},
      journal = {Cardiology and Cardiovascular Research},
      volume = {4},
      number = {2},
      pages = {59-66},
      doi = {10.11648/j.ccr.20200402.15},
      url = {https://doi.org/10.11648/j.ccr.20200402.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200402.15},
      abstract = {Background: Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy, and deteriorating function, which if uninterrupted leads to congestive heart failure (CHF) and a poor clinical outcome, begins in some patients with acute myocardial infarction (AMI) even after successful percutaneous coronary intervention (PCI). Aims: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four acute myocardial infarction patients. A thorough physical examination, electrocardiography (ECG) and a complete echocardiographic assessment, including speckle tracking study, was performed two days after PCI and then a follow up echocardiography with speckle tracking study was done two months afterwards. Patients were then divided into two groups based on the presence of remodelling (R+, R-). RESULTS: at baseline study global longitudinal strain (GLS) (-11.14±0.5 VS -16.78±0.4, P<0.0001), longitudinal strain rate (LSr) (-1.01±0.05 VS -1.07±0.04, P<0.0001), culprit longitudinal strain (CulLS) (-9.74±0.59 VS -15.68±0.49, P<0.0001), culprit longitudinal strain rate (CulLSr) (-0.95±0.05 VS -1.02±0.04, P<0.0001) were all lower in group R+ than in R-. In the follow up study, all strain parameters studied were significantly lower in the R+ group than R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively) and (specificities of 95% and 96.7% respectively). CONCLUSION: Our findings show that impaired indices LV deformation detected two days after successful PCI for AMI may provide predictive value in detecting LV remodelling.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients After Myocardial Infarction
    AU  - Moustafa Kamal Eldin Ibrahim
    AU  - Khalied Ahmad Emam El-khashab
    AU  - Tamer Mosaad Elsaed Ragab
    Y1  - 2020/04/30
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ccr.20200402.15
    DO  - 10.11648/j.ccr.20200402.15
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 59
    EP  - 66
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20200402.15
    AB  - Background: Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy, and deteriorating function, which if uninterrupted leads to congestive heart failure (CHF) and a poor clinical outcome, begins in some patients with acute myocardial infarction (AMI) even after successful percutaneous coronary intervention (PCI). Aims: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four acute myocardial infarction patients. A thorough physical examination, electrocardiography (ECG) and a complete echocardiographic assessment, including speckle tracking study, was performed two days after PCI and then a follow up echocardiography with speckle tracking study was done two months afterwards. Patients were then divided into two groups based on the presence of remodelling (R+, R-). RESULTS: at baseline study global longitudinal strain (GLS) (-11.14±0.5 VS -16.78±0.4, P<0.0001), longitudinal strain rate (LSr) (-1.01±0.05 VS -1.07±0.04, P<0.0001), culprit longitudinal strain (CulLS) (-9.74±0.59 VS -15.68±0.49, P<0.0001), culprit longitudinal strain rate (CulLSr) (-0.95±0.05 VS -1.02±0.04, P<0.0001) were all lower in group R+ than in R-. In the follow up study, all strain parameters studied were significantly lower in the R+ group than R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively) and (specificities of 95% and 96.7% respectively). CONCLUSION: Our findings show that impaired indices LV deformation detected two days after successful PCI for AMI may provide predictive value in detecting LV remodelling.
    VL  - 4
    IS  - 2
    ER  - 

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Author Information
  • Cardiology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

  • Cardiology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

  • Cardiology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

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