Early resolution of ST-segment elevation after reperfusion therapy for acute myocardial infarction: Its relation to echocardiography-determined left ventricular global and regional function and deformation

• Published in: Journal of electrocardiology 2015-03, Vol.48 (2), p.241-248
• Main Authors: Ding, Song, MD, Zhao, Hang, MD, Qiao, Zhi-qing, MD, Yang, Fan, MD, Wang, Wei, MD, Gao, Ling-chen, MD, Kong, Ling-cong, MD, Xu, Ren-de, MD, PhD, Ge, Heng, MD, PhD, Shen, Xue-dong, MD, PhD, Pu, Jun, MD, PhD, He, Ben, MD, PhD, FACC
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular; Coronary Angiography; Echocardiography; Echocardiography - methods; Electrocardiography; Female; Humans; Male; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Myocardial Infarction - surgery; Myocardial Reperfusion - methods; Percutaneous Coronary Intervention; ST-segment elevation myocardial infarction; ST-segment resolution; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/j.jelectrocard.2014.12.003

Abstract Aims To evaluate the relationships between ST-segment resolution (STR) and echocardiography-determined left ventricular (LV) global and regional function and deformation in the sub-acute phase of STEMI. Methods and Results STR, defined as either complete (≥ 70%) or incomplete (< 70%), was evaluated 60 minutes after primary percutaneous coronary intervention (PCI) of 84 STEMI patients. Conventional two-dimensional (2D) echocardiography and 2D speckle-tracking echocardiography (STE) were performed at 3–7 days after reperfusion. LV deformation [including the infarction-related regional longitudinal (RLS), circumferential (RCS), and radial (RRS) strains, and global longitudinal (GLS), circumferential (GCS), and radial (GRS) strains] was measured by 2D STE. LV segmental function was assessed by wall motion score index (WMSI). Patients in incomplete vs. complete STR groups had higher WMSI ( p < 0.001); decreased peak amplitude of RLS ( p < 0.001), RCS ( p = 0.008), RRS ( p = 0.002); and decreased peak amplitude of GLS ( p < 0.001), GCS ( p < 0.001), GRS ( p = 0.003). RLS ( r = 0.27, p = 0.015) and GLS ( r = 0.33, p = 0.003) were best correlates of STR at the regional and global level, respectively. Conclusions STR correlated with global and regional LV function and deformation in patients with sub-acute phase of STEMI after PCI. RLS and GLS were the strongest correlates of STR at the regional and global levels, respectively.