Sunday, 28 August 2011

Purpose: Left ventricle (LV) remodeling is a relatively common and unfavorable event occurring after acute myocardial infarction (AMI). Development of LV remodeling after AMI is a complex process influenced by many factors and early identification of it is essential. We sought to investigate the differences of LV circumferential, radial and longitudinal strain in patients with LV remodeling and without LV remodeling after AMI. Methods: A total of 117 patients (mean age 57.1 years ±11.2) with a first AMI were included into the study. Within 24-72 hours of the onset of AMI symptoms, 2- dimensional echocardiography with speckle-tracking imaging for evaluation of LV strain was performed. At 4 months, 38 patients (32.5%) with and 79 (69.5%) without LV remodeling were identified. LV remodeling was defined as a 15% increase from the baseline in LV end diastolic volume. Results: The LV remodeling group had a higher troponin I level (p<0.05) and more anterior wall infarcts (p<0.01). LV ejection fraction (49.6%±7.9 vs. 54.2%±7.8, p<0.01) and LV end systolic volume (45.7 ml±15.6 vs. 38.9ml±12.7, p<0.05) at baseline were significantly different between the LV remodeling and without LV remodeling groups. Strain analysis of LV revealed no any differences in global circumferential (-13.0%±4.5 vs. -14.5%±4.5, p>0.05) and global radial strain (26.4%±11.9 vs. 28.8%±9.7, p>0.05) at the baseline. LV remodeling group had decreased global systolic longitudinal LV strain if compare to the patients without LV remodeling (-11.2%±4.1 vs. -14.2%±3.8, p<0.01). According to receiver operating characteristics analysis, peak systolic LV longitudinal strain of -10.5% (area under the curve 0.77, sensitivity 75%, specificity 78%) was found to be a significant predictor of LV remodeling. Conclusions: Strain analysis is a novel technique in LV function assessment after myocardial infarction. LV longitudinal strain may ap[...].