Iwakura Katsuomi, Onishi Toshinari, Okamura Atsunori, Koyama Yasushi, Inoue Koichi, Nagai Hiroyuki, Hirao Yuko, Tanaka Koji, Iwamoto Mutsumi, Tanaka Nobuaki, Nakatani Daisaku, Hikoso Shungo, Sakata Yasuhiko, Sakata Yasushi, Fujii Kenshi
Division of Cardiology, Sakurabashi Watanabe Hospital Osaka Japan.
Department of Cardiology, National Hospital Organization Osaka National Hospital Osaka Japan.
Circ Rep. 2021 Aug 20;3(9):530-539. doi: 10.1253/circrep.CR-21-0076. eCollection 2021 Sep 10.
Global longitudinal strain (GLS) can predict prognosis after myocardial infarction (MI). Tissue mitral annular displacement (TMAD) is another index of longitudinal left ventricular deformity, and is less dependent on image quality than GLS. We investigated the relationship between TMAD and GLS, and their ability to predict outcomes after MI. GLS and TMAD were measured on echocardiograms 2 weeks after MI in 246 consecutive patients (median age 62 years, 85.7% male). TMAD was measured from apical 4- and 2-chamber views (TMAD and TMAD, respectively), and a mean value (TMAD) was calculated. TMAD, TMAD, and GLS were successfully measured in 240 (97.5%), 210 (85.3%) and 214 patients (87.0%), respectively. All TMAD parameters were significantly correlated with GLS (R=0.71-0.75) and left ventricular ejection fraction (LVEF; R=0.48-0.53). TMAD parameters were weakly correlated with peak creatine kinase (CK; R=0.20) and CK-MB (R=0.21-0.25). GLS and TMAD were significantly associated with LVEF after 6 months (R=0.48-0.53) and all-cause mortality during the follow-up period (median 1,242 days). TMAD discriminated patients with higher all-cause mortality when patients were divided into 3 groups, namely upper 25%, middle range, and lower 25% of TMAD (P=0.041, log-rank test). GLS detected high-risk patients using 15.0% as a cut-off value. TMAD could be a simple and reliable alternative to GLS for predicting outcomes in patients with MI.
整体纵向应变（GLS）可预测心肌梗死（MI）后的预后。组织二尖瓣环位移（TMAD）是左心室纵向变形的另一个指标，并且比GLS对图像质量的依赖性更小。我们研究了TMAD与GLS之间的关系，以及它们预测MI后结局的能力。对246例连续患者（中位年龄62岁，85.7%为男性）在MI后2周进行超声心动图检查时测量GLS和TMAD。从心尖四腔心和两腔心视图分别测量TMAD（分别为TMAD₄和TMAD₂），并计算平均值（TMAD）。分别在240例（97.5%）、210例（85.3%）和214例患者（87.0%）中成功测量了TMAD₄、TMAD₂和GLS。所有TMAD参数均与GLS（R = 0.71 - 0.75）和左心室射血分数（LVEF；R = 0.48 - 0.53）显著相关。TMAD参数与肌酸激酶峰值（CK；R = 0.20）和肌酸激酶同工酶（CK - MB；R = 0.21 - 0.25）弱相关。6个月后GLS和TMAD与LVEF显著相关（R = 0.48 - 0.53），并且与随访期间的全因死亡率（中位1242天）显著相关。当将患者分为TMAD的上25%、中间范围和下25%三组时，TMAD能够区分全因死亡率较高的患者（P = 0.041，对数秩检验）。GLS以15.0%作为临界值检测高危患者。对于预测MI患者的结局，TMAD可能是一种简单且可靠的替代GLS的方法。
