Can changes in systolic longitudinal deformation quantify regional myocardial function after an acute infarction? An ultrasonic strain rate and strain study☆☆☆

Abstract 

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 (ϵ) 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 ϵ decreased significantly with segmental asynergy severity and could identify infarct-involved segments (group B3) with a sensitivity/specificity of 85% (systolic SR and ϵ 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. (J Am Soc Echocardiogr 2002;15:723-30.)