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Saleh, A., El-Amin, A., El-Baz, M., Negm, H. (2019). Assessment of Myocardial Viability After Acute ST- Elevated Myocardial Infarction Using Stress Speckle Tracking Echocardiography and Cardiac MRI. The Egyptian Journal of Hospital Medicine, 77(3), 5173-5182. doi: 10.21608/ejhm.2019.53303
Ahmed Saleh; Ali El-Amin; Mohamed El-Baz; Hany Negm. "Assessment of Myocardial Viability After Acute ST- Elevated Myocardial Infarction Using Stress Speckle Tracking Echocardiography and Cardiac MRI". The Egyptian Journal of Hospital Medicine, 77, 3, 2019, 5173-5182. doi: 10.21608/ejhm.2019.53303
Saleh, A., El-Amin, A., El-Baz, M., Negm, H. (2019). 'Assessment of Myocardial Viability After Acute ST- Elevated Myocardial Infarction Using Stress Speckle Tracking Echocardiography and Cardiac MRI', The Egyptian Journal of Hospital Medicine, 77(3), pp. 5173-5182. doi: 10.21608/ejhm.2019.53303
Saleh, A., El-Amin, A., El-Baz, M., Negm, H. Assessment of Myocardial Viability After Acute ST- Elevated Myocardial Infarction Using Stress Speckle Tracking Echocardiography and Cardiac MRI. The Egyptian Journal of Hospital Medicine, 2019; 77(3): 5173-5182. doi: 10.21608/ejhm.2019.53303

Assessment of Myocardial Viability After Acute ST- Elevated Myocardial Infarction Using Stress Speckle Tracking Echocardiography and Cardiac MRI

Article 16, Volume 77, Issue 3, October 2019, Page 5173-5182  XML PDF (692.55 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2019.53303
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Authors
Ahmed Saleh email 1; Ali El-Amin2; Mohamed El-Baz2; Hany Negm1
1*Cardiology unit, Research Institute of Ophthalmology, Ministry of Scientific Research and Technology, Al-Azhar University, Cairo, Egypt
2Cardiology department, Al-Azhar University, Cairo, Egypt
Abstract
Background: Speckle-tracking echocardiography has emerged as a unique technique for accurately evaluating myocardial function by analyzing the motion of speckles identified. Speckle-tracking measured under stress may offer an opportunity to improve the detection of dynamic regional abnormalities and myocardial viability. Objective: The aim of the current study was to evaluate stress speckle tracking to detect myocardial viability in comparison to cardiac MRI in post-STEMI patients. Patients and methods: 74 patients were prospectively enrolled in 18-month’s study. Dobutamine stress echocardiography was performed 4 days post-infarction accompanied with automated functional imaging analysis of left ventricle during rest and then during low dose stress. All patients underwent a follow up stress echocardiography at 3 months with speckle tracking analysis. Cardiac MRI took place concomitantly at 4 days post-infarction and 3 months. Results: Investigating strain rate obtained with stress speckle tracking after revascularization predicted the extent of myocardial scar, determined by contrast-enhanced magnetic resonance imaging. A good correlation was found between the global strain and total infarct size (R 0.75, p< 0.001). Furthermore, a clear inverse relationship was found between the segmental strain and the transmural extent of infarction in each segment. Meanwhile it provided 81.82% sensitivity and 82.6% specificity to detect transmural from non-transmural infarction at a cut-off value of -10.15. Conclusion: Strain rate obtained from speckle tracking during stress is a novel method of detecting myocardial viability after STEMI. Moreover, it carries a promising role in post-myocardial infarction risk stratification with a reasonable prediction of reversible cardiac-related hospital re-admission.
Keywords
STEMI; Stress Echocardiography; speckle tracking; Cardio-MRI
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