Comparison of Left Ventricular Ejection Fraction and Left Ventricular Global Strain as Determinants of Infarct Size in Patients with Acute Myocardial Infarction

Sjøli, Benthe; Ørn, Stein; Grenne, Bjørnar; Vartdal, Trond; Smiseth, Otto A.; Edvardsen, Thor; Brunvand, Harald

doi:10.1016/j.echo.2009.07.027

« Previous Next »Journal of the American Society of Echocardiography
Volume 22, Issue 11 , Pages 1232-1238, November 2009

Comparison of Left Ventricular Ejection Fraction and Left Ventricular Global Strain as Determinants of Infarct Size in Patients with Acute Myocardial Infarction

Benthe Sjøli, MD
- Department of Medicine, Sørlandet Hospital HF, Arendal, Norway
Stein Ørn, MD
- Department of Cardiology, Stavanger University Hospital, Oslo, Norway
Bjørnar Grenne, MD
- Department of Medicine, Sørlandet Hospital HF, Arendal, Norway
Trond Vartdal, MD
- Department of Cardiology, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
Otto A. Smiseth, MD, PhD
- Department of Cardiology, 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
Harald Brunvand, MD, PhD
- Department of Medicine, Sørlandet Hospital HF, Arendal, Norway
- Reprint requests: Harald Brunvand, MD, PhD, Head, Section of Cardiology, Department of Medicine, Sørlandet Hospital HF, Arendal, 4809 Arendal, Norway

published online 08 October 2009.

Background

The aim was to compare left ventricular ejection fraction (LVEF) and left ventricular (LV) global strain by speckle tracking as predictors of final infarct size.

Methods

LV global strain and LVEF by echocardiography were assessed in the acute phase and after revascularization in 39 patients with ST-elevation myocardial infarction treated with thrombolysis.

Results

After revascularization, global strain and LVEF correlated well with infarct size measured by contrast-enhanced cardiac magnetic resonance. A cutoff value of −15.0% for global strain had a sensitivity of 90% and a specificity of 86% to identify myocardial infarcts larger than 20%. Interobserver variability, expressed by intraclass correlation coefficients, for global strain and LVEF was 0.91 and 0.72, respectively.

Conclusions

LV global strain is a more precise diagnostic predictor of large infarcts compared with LVEF and is more reproducible. Global strain measured after revascularization demonstrates advantages over LVEF in the evaluation of LV injury in patients with ST-elevation myocardial infarction.

Keywords: Cardiac magnetic resonance, Ejection fraction, Global strain, Myocardial infarction