Exploratory echocardiographic strain parameters for the estimation of myocardial infarct size in ST-elevation myocardial infarction.
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
revised:
28
03
2021
received:
06
12
2020
accepted:
31
03
2021
pubmed:
13
6
2021
medline:
16
10
2021
entrez:
12
6
2021
Statut:
ppublish
Résumé
Outcome after ST-elevation myocardial infarction (STEMI) can be most reliably estimated by cardiac magnetic resonance (CMR) imaging. However, CMR is expensive, laborious, and has only limited availability. In comparison, transthoracic echocardiography (TTE) is widely available and cost-efficient. TTE strain parameters can be used as surrogate markers for CMR-measured parameters after STEMI. TTE strain analysis was performed of patients included in a controlled, prospective STEMI trial (NCT01777750) 4 ± 2 days after the event. Longitudinal peak strain (LPS), post-systolic shortening, early systolic lengthening, early systolic lengthening time, and time to peak shortening were measured, and index parameters were computed. Global longitudinal strain (GLS) and ejection fraction (EF) were compiled. Parameters were correlated with CMR-measured variables 4 ± 2 days after STEMI. In 70 STEMI patients, high quality CMR and TTE data were available. Highest correlation with CMR-measured infarct size was observed with GLS (r = 0.577, p < 0.0001), LPS (r = 0.571, p < 0.0001), and EF (r = -0.533, p < 0.0001). Highest correlation with CMR-measured area at risk was observed with GLS (r = 0.666, p < 0.0001), LPS (0.661, p < 0.0001) and early systolic lengthening index (r = 0.540, p < 0.0001). Receiver operating characteristics for the detection of large infarcts (quartile with highest infarct size) showed the highest area under the curve for LPS, GLS, EF, and myocardial dysfunction index. Multiple linear regression displayed the best association between GLS and infarct size. Exploratory strain parameters significantly correlate with CMR-measured area at risk and infarct size and are of potential interest as endpoint variables in clinical trials.
Sections du résumé
BACKGROUND
BACKGROUND
Outcome after ST-elevation myocardial infarction (STEMI) can be most reliably estimated by cardiac magnetic resonance (CMR) imaging. However, CMR is expensive, laborious, and has only limited availability. In comparison, transthoracic echocardiography (TTE) is widely available and cost-efficient.
HYPOTHESIS
OBJECTIVE
TTE strain parameters can be used as surrogate markers for CMR-measured parameters after STEMI.
METHODS
METHODS
TTE strain analysis was performed of patients included in a controlled, prospective STEMI trial (NCT01777750) 4 ± 2 days after the event. Longitudinal peak strain (LPS), post-systolic shortening, early systolic lengthening, early systolic lengthening time, and time to peak shortening were measured, and index parameters were computed. Global longitudinal strain (GLS) and ejection fraction (EF) were compiled. Parameters were correlated with CMR-measured variables 4 ± 2 days after STEMI.
RESULTS
RESULTS
In 70 STEMI patients, high quality CMR and TTE data were available. Highest correlation with CMR-measured infarct size was observed with GLS (r = 0.577, p < 0.0001), LPS (r = 0.571, p < 0.0001), and EF (r = -0.533, p < 0.0001). Highest correlation with CMR-measured area at risk was observed with GLS (r = 0.666, p < 0.0001), LPS (0.661, p < 0.0001) and early systolic lengthening index (r = 0.540, p < 0.0001). Receiver operating characteristics for the detection of large infarcts (quartile with highest infarct size) showed the highest area under the curve for LPS, GLS, EF, and myocardial dysfunction index. Multiple linear regression displayed the best association between GLS and infarct size.
CONCLUSION
CONCLUSIONS
Exploratory strain parameters significantly correlate with CMR-measured area at risk and infarct size and are of potential interest as endpoint variables in clinical trials.
Identifiants
pubmed: 34117638
doi: 10.1002/clc.23608
pmc: PMC8259148
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
925-931Subventions
Organisme : Austrian Science Fund
ID : APKLI209
Organisme : Vienna Major Fund
ID : 15214
Informations de copyright
© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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