Two‐Dimensional Speckle Tracking Echocardiography for the Prediction of Reversible Myocardial Dysfunction after Acute Myocardial Infarction: Comparison with Magnetic Resonance Imaging

BACKGROUND: We aimed to determine the predictive value of longitudinal, circumferential, and radial strains by two-dimensional speckle tracking echocardiography (2DSTE) for improvement in cardiac function after acute myocardial infarction (AMI) compared with that of contrast-enhanced cardiac magnetic resonance imaging (ceMRI). METHODS: In 35 patients with first-time AMI, myocardial viability was assessed to predict recovery of function at follow-up (7 ± 2 months), prospectively. For each left ventricular segment, each peak strains were determined using 2DSTE, and the relative extent of hyperenhancement was assessed using ceMRI. RESULTS: Of 176 segments with impaired function early after AMI, 99 segments showed regional recovery. Compared with segments showing functional improvement, those that failed to recover had lower peak radial (20 ± 16% vs. 32 ± 21%; P < 0.001), circumferential (-10 ± 5% vs. -20 ± 6%; P < 0.001), and longitudinal (-10 ± 5% vs. -14 ± 5%; P < 0.001) strain and a greater extent of hyperenhancement (71 ± 22% vs. 27 ± 20%; P < 0.001). Among strain parameters, circumferential strain yielded greater area under the curve (AUC; 0.899) than radial and longitudinal strain (0.682 and 0.718, respectively). The predictive value of circumferential strain (sensitivity 81.0%, specificity 79.6%, at a cutoff value of -14.3%) could be comparable to that of hyperenhancement (sensitivity 86.2%, specificity 83.9%, AUC 0.921, at a cutoff value of 47%) (P = 0.439). CONCLUSION: Circumferential strain can identify reversible myocardial dysfunction after AMI with a diagnostic ability comparable to that of ceMRI.