Why the study?
The study was designed to evaluate left ventricular systolic function in elderly patients with NSTEMI and STEMI using real-time three-dimensional echocardiography and two-dimensional speckle tracking imaging.
Can RT-3DE and STI detect differences in left ventricular systolic function between elderly patients with NSTEMI and STEMI after PCI?
Can RT-3DE and STI detect differences in left ventricular systolic function between elderly patients with NSTEMI and STEMI after PCI?
RT-3DE and STI can sensitively differentiate the extent of left ventricular transmural damage and systolic dysfunction between elderly patients with NSTEMI and STEMI.
May detect residual injury LVEF underestimates after elderly AMI PCI; leaves open whether strain imaging should change surveillance.
Aim: To evaluate the left ventricular (LV) systolic function in elderly with non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI) using real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (STI). Methods: Forty NSTEMI and forty STEMI patients after undergoing percutaneous coronary artery intervention (PCI) were enrolled. The myocardial segments were supplied by the infarct-related artery (Myo- IRA ) which were indicated by the selective coronary arteriography (SCA). The LV end-diastolic volume (LVEDV), end-systolic volume (LVESV), stroke volume (LVSV) and ejection fraction (LVEF) were acquired by 4D LV Volume Tom Tec. LV longitudinal peak systolic strain (LPSS), radial peak systolic strain (RPSS), circumferential peak systolic strain (CPSS) of Myo- IRA segments, LV rotational peak degree in the base (rot- base ) and in the apex (rot- apex ), and twist were acquired by strain analysis software. Forty older healthy individuals were included as normal controls. Results: The LVEF of the NSTEMI and STEMI patients at 1 week after PCI were significantly lower ( P < 0.05), then, this parameter was improved in both groups after 3 months, but was still significantly lower than that of the controls ( P < 0.05). The LPSS, RPSS, CPSS of the Myo −IRA segments, rot −Base , rot −Apex and twist in both groups were significantly lower than those in the controls. The LPSS and CPSS of the Myo-IRA segments, rot −Base , rot −Apex and twist in NSTEMI patients were obviously higher than those in STEMI patients in 1 week and 3 months after PCI ( P < 0.05). After 3 months, the RPSS of NSTEMI patients was improved notably and was obviously higher than that of STEMI patients ( P < 0.05). All these values in STEMI and NSTEMI patients were improved after 3 months, apart from LPSS in STEMI patients ( P > 0.05), but were still significantly lower than those in the controls ( P < 0.05). Conclusion: RT-3DE and STI can sensitively assess LV systolic function with different extents of transmural damage.
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A 2022 study studied this question.
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