ABSTRACT
Background: speckle tracking echocardiography [STE] enables objective assessment of left ventricular [LV] function through analysis of myocardial strain and strain rate. This study aims to determine the sensitivity and specificity of global longitudinal strain [GLS] and global longitudinal strain rate [GLSR] of LV in assessment of myocardial Jirnction compared to peak wall motion score index [WMSI] at dobutamine stress echocardiography [DSE]
Methods: fifty patients with suspected or known myocardial ischemia were evaluated by conventional echocardiography, DSE, STE and coronary angiography [CA]. Standard apical views were wed to calculate GLS and GHR by STE. WMSI was calculated at peak stress during DSE. Significant coronary lesion[s] were indicated by >/= 50% luminal stenosis in CA
Results: GLS and GLSR were significantly lower in patients with significant CAD than those with
Conclusion: GLS and GLSR are negatively correlated to peak WMSI. Both deformation parameters can predict significant lesion[s] in CA, but with lower diagnostic accuracy than DSE
ABSTRACT
The major determinants of short and long-term prognosis after myocardial infarction [MI] are MI size as well as the final scar size. Clinical and electrocardiographic [ECG], admission variables were studied in 60 consecutive patients admitted with their first acute anterior ST-segment elevation MI of <6 hours duration. Predischarge low-dose dobutamine stress echo was done to the patients unless contraindicated to measure MI size [Resting wall motion score index; WMSI] and final scar size [low-dose WMSI]. Out of the 19 variables studied only 4 variables were significant univariate predictors of both MI size and scar size; QRS distortion, higher Killip class, number of leads with ST segment elevation and Selvester score. Other 3 variables predicted only MI size; history of chronic stable angina, sum of ST elevation, and maximum creatinine kinase level. Of the admission variables, the multivariate predictors of larger MI size were QRS distortion and higher baseline Killip class. For scar size the only multivariate predictor was Killip class. The pre-discharge multivariate model added Selvester score to the above admission variables as a significant multivariable predictor to both MI and scar sizes. The presence of QRS distortion in the admission ECG can independently predict large MI ALT but not essentially a large final scar size. Both can be independently predicted by the admission Killip class as well as by Selvester score in the predischarge ECG