Left Ventricle Longitudinal Deformation Assessment by Mitral Annulus Displacement or Global Longitudinal Strain in Chronic Ischemic Heart Disease: Are They Interchangeable?

Gjesdal, Ola; Vartdal, Trond; Hopp, Einar; Lunde, Ketil; Brunvand, Harald; Smith, Hans-Jørgen; Edvardsen, Thor

doi:10.1016/j.echo.2009.04.023

« Previous Next »Journal of the American Society of Echocardiography
Volume 22, Issue 7 , Pages 823-830, July 2009

Left Ventricle Longitudinal Deformation Assessment by Mitral Annulus Displacement or Global Longitudinal Strain in Chronic Ischemic Heart Disease: Are They Interchangeable?

Ola Gjesdal, MD
- Department of Cardiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
Trond Vartdal, MD
- Department of Cardiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
Einar Hopp, MD
- Department of Radiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
Ketil Lunde, MD, PhD
- Department of Cardiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
Harald Brunvand, MD, PhD
- Department of Cardiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
Hans-Jørgen Smith, MD, PhD
- Department of Radiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
Thor Edvardsen, MD, PhD
- Department of Cardiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
- Reprint requests: Thor Edvardsen, MD, PhD, Rikshospitalet University Hospital, Department of Cardiology, N-0027 Oslo, Norway.

published online 08 June 2009.

Oslo, Norway

Background

Increasing infarct mass is associated with impaired prognosis in chronic ischemic heart disease. Global strain by echocardiographic assessment relates closely to infarct mass assessed by delayed enhancement magnetic resonance imaging but requires deformation analysis in a 16-segment model of the left ventricular. Mitral annular (MA) displacement reflects longitudinal left ventricular deformation and could provide similar information.

Methods

Global longitudinal strain and MA displacement by Doppler tissue imaging were assessed in 61 patients 9 months after first myocardial infarctions and compared with global myocardial infarct mass assessed using contrast-enhanced magnetic resonance imaging.

Results

Both indices significantly separated medium-sized infarcts from small or large infarcts (P < .05) and correlated significantly with global infarct mass (P < .01 for both). There was a good correlation between global strain and MA displacement (r = 0.65, P < .01). The sensitivities and specificities to identify myocardial infarcts differed only slightly among the indices, but global longitudinal strain tended to be the best.

Conclusions

Longitudinal deformation by global strain or MA displacement correlated well with myocardial infarct mass and could discriminate between different extents of myocardial infarctions. Global longitudinal strain tended to be better, especially for the identification of the smallest infarcts.

Keywords: Contrast-enhanced MRI, Strain, Mitral annulus, Displacement, Ischemic heart disease