ABSTRACT
We sought to evaluate the impact of different therapeutic strategies on longitudinal regional myocardial systolic function in the early phase of acute myocardial infarction using strain rate imaging. A total of 38 patients [34 males], with first acute myocardial infarction [AMI] were evaluated. Our patients were divided into 3 groups according to the kind of therapy. The mean age of the patients was 55 +/- 9.4 years [range: 39- 75 years]. Mean left ventricular ejection fraction [LVEF] in the patients was 41 +/- 10.7%. Primary percutaneous coronary intervention [PCI] was performed in 10 patients. Sixteen patients were treated by thrombolytic therapy using streptokinase [SK] and 12 were followed-up conservatively. All patients underwent a comprehensive echocardiography study including SR imaging within 3- 5 days after AMI. The parameters measured included peak systolic strain [peak epsilon] and strain rate [SRs], end-systolic strain [epsilon es], post systolic shortening [PSS], time to peak systolic strain rate [tSRs], time to end of shortening [teSRs], post systolic strain [PS epsilon], post-systolic strain index [PSI], PSS ratio [PSS/ epsilon [Max]] and peak postsystolic strain rate [SRPSS]. There was not any association either between WMSI and ta [P=0.4], or MI location and PSS ratio [P=0.13]. But there was an inverse relationship between WMSI and mean SRS, especially when WMSI was more pronounced. A significant relationship was found between t epsilon epsilon and teSRs with the kind of therapy [shorter in PCI group [P= 0.04]. Using a simple linear regression model, no association was found between PSS ratio and SRs [a=0.056, P =0.70], PSI and teSRs [beta= -0.772, P=0.12]. Simple linear regression model showed a weak but significant relationship between PSI and Median t epsilon [beta = -0.851, P =0.04; r =0.33]. Our study showed that PCI resulted in early recovery of regional systolic function of infarcted myocardium during the early stage of acute myocardial infarction