Doğan Cem, Bayram Zübeyde, Candan Özkan, Omaygenç Onur, Yılmaz Fatih, Acar Rezzan Deniz, Akbal Özgür Yaşar, Kaymaz Cihangir, Özdemir Nihal
Cardiology Department, Kartal Kosuyolu Education and Research Hospital, İstanbul, Turkey.
Faculty of Medicine, Cardiology Department, Medipol University, İstanbul, Turkey.
Echocardiography. 2017 Mar;34(3):376-382. doi: 10.1111/echo.13457. Epub 2017 Mar 1.
This study aimed to determine the myocardial damage (infarct size provided by cardiac single-photon emission tomography) in early stages of the infarction using longitudinal strain and rotational parameters of the left ventricle.
The study included 66 patients with anterior myocardial infarction (AMI) and 62 patients with inferior myocardial infarction (IMI) who underwent primary percutaneous intervention as well as a control group consisting of 50 healthy subjects. LV rotational parameters based on parasternal short-axis views in basal and apical planes and global longitudinal strain were measured with apical four-chamber, apical two-chamber, and apical long-axis views.
There was a significant positive correlation between infarct size and GLPSavg (r=-.55 <.001), GTOR angle (r=-.52, P<.001), apical rotation angle (r=-.40 <.001, and EF (r=-.43, <.001). While cutoff values were GLPSavg: 11.9 (AUC=0.78), GTOR angle: 11.4° (AUC=0.77), apical rotation angle: 7.1° (AUC=0.76) for patients with an infarct size greater than 20%, the cutoff values were GLPSavg: 10.7 (AUC=0.75), GTOR angle: 8.7° (AUC=0.86), apical rotation angle: 4.35° (AUC=0.87) for those with an infarct size greater than 40%.
GLPSavg, GTOR angle, and apical rotation angle values may be used to determine the extent of infarction in early post-MI period, thereby allowing precautions to be taken for remodeling in early stages.
本研究旨在利用左心室的纵向应变和旋转参数来确定梗死早期的心肌损伤(通过心脏单光子发射断层扫描提供梗死面积)。
该研究纳入了66例接受直接经皮冠状动脉介入治疗的前壁心肌梗死(AMI)患者和62例下壁心肌梗死(IMI)患者,以及由50名健康受试者组成的对照组。基于心底和心尖平面胸骨旁短轴视图的左心室旋转参数以及整体纵向应变通过心尖四腔心、心尖两腔心和心尖长轴视图进行测量。
梗死面积与GLPSavg(r = -0.55,P <.001)、GTOR角(r = -0.52,P <.001)、心尖旋转角(r = -0.40,P <.001)和EF(r = -0.43,P <.001)之间存在显著正相关。对于梗死面积大于20%的患者,截断值为GLPSavg:11.9(AUC = 0.78)、GTOR角:11.4°(AUC = 0.77)、心尖旋转角:7.1°(AUC = 0.76);对于梗死面积大于40%的患者,截断值为GLPSavg:10.7(AUC = 0.75)、GTOR角:8.7°(AUC = 0.86)、心尖旋转角:4.35°(AUC = 0.87)。
GLPSavg、GTOR角和心尖旋转角的值可用于确定心肌梗死后早期梗死范围,从而在早期采取预防重构的措施。