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ȣ - 510530 193 |
| Peak Systolic Strain Measured by Automated Function Imaging Is More Sensitive Predictor of Coronary Perfusion than Wall Motion Score Index in Patients with Acute Myocardial Infarction |
| 전남대학교병원 심장센터 |
| 조정선, 김계훈, 이지선, 김혜숙, 조숙희, 임상춘, 정종원, 심두선, 윤현주, 윤남식 문재연, 홍영준, 박형욱, 김주한, 안영근, 정명호, 조정관, 박종춘, 강정채 |
Backgroud and Objectives Measurement of strain or strain rate by tissue Doppler echocardiography is a very useful tool for the evaluation of regional myocardial function, but it is often limited by technical difficulty or time consuming nature. The aim of this study was to investigate the usefulness of peak systolic strain (PSS) measured by automated function imaging (AFI) in predicting coronary perfusion before coronary angiography (CAG) in patients with acute myocardial infarction (AMI). Methods A total of 60 patients with AMI who underwent successful primary percutaneous coronary intervention (PCI) within 12 hours form the onset of chest pain were divided into two groups; the patients with occlusion of infarct-related artery (IRA) (group I, 34 patients, 63.7±15.2 years, 29 males) versus the patients with patent IRA (group II, 26 patients, 64.3±11.4 years, 14 males). PSS measured by AFI were compared with wall motion score (WMS) or wall motion score index (WMSI) between the groups. Results Mean PSS was significantly decreased in group I than in group II (-10.32±4.20 vs -13.06±4.75%, p=0.021), but total WMS (25.99±6.44 vs 22.50±8.56, p=ns) or WMSI (1.58±0.41 vs 1.39±0.54, p=ns) were not different between the groups. PSS of infarct related segments were significantly decreased in group I than in group II (-4.43±5.82 vs -11.37±5.75%, p<0.001). WMSI of infarct related segments were significantly higher in group I than in group II (1.99±0.79 vs 1.47±0.60, p=0.007). By receiver operation curve analysis, the area under the curve to predict coronary occlusion was 0.796 in PSS of infarct related segments and 0.699 in WMSI of infarct related segments. The optimal cutoff value to predict IRA occlusion was -9.35 in PSS of infarct segments (sensitivity: 82.4%, specificity: 65.4%) and 1.40 in WMSI of infarct segments (sensitivity: 73.5%, specificity: 61.5%). Conclusion The results of this study demonstrated that PSS measured by AFI is more sensitive predictor of IRA occlusion than WMS or WMSI before CAG. Routine measurement of PSS by AFI can be a very useful tool in risk stratification of AMI.
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