Left Ventricle Longitudinal Deformation Assessment by Mitral Annulus Displacement or Global Longitudinal Strain in Chronic Ischemic Heart Disease: Are They Interchangeable?
published online 08 June 2009.
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.