Detection Of AMI After Reperfusion Therapy In Transmural Mechanical State Changes By 2D-STI

ObjectiveIn this study, by using two-dimensional speckle tracking (2D-STI), we observed left ventricular anterior wall acute myocardial infarction after successful reperfusion therapy endocardial and epicardial myocardial recovery, we analyzed left ventricular anterior wall acute myocardial infarction before and after reperfusion in patients with endocardial myocardial and epicardial transmural mechanical changes, and we evaluated before and after reperfusion in AMI transmural mechanics in the feasibility and clinical value by 2D-STI.MethodWith 68 patients of left ventricular anterior wall acute myocardial infarction, by using 2D-STI technology, we acquired apical long-axis, three-chamber, apical two-chamber at the level of left ventricular papillary muscle endocardium, endicardium strain-time curve, we measured infarction and non-infarcted myocardial segments endocardial, epicardial strain parameters:longitudinal peak strain, and we got the result comparing with the control group of 39.Result1. Changes of Infarction subendocardial segment in two-dimensional strain.Infarcted segments with subendocardial infarction LSpeak group of non-infarct segment and the control group reduced significantly than the corresponding segments(P<0.01), Duration of TPSLs extended significantly with reperfusion, subendocardial infarction segments of myocardial LSpeak recovered gradually. TPSLS shortened. After 3 months of the success of reperfusion therapy, it has not recovered to normal levels. Compared with the MI group and the non-infarct segments and the control group, there were statistically signification (P<0.05) after successful reperfusion therapy from 3 to 7 days and 3 months.2. Changes of infarction subepicardial infracted myocardial segments dimensional strain.Compared with the group of non-infarct segments and the corresponding segments of the control group, infarction subepicardial infracted myocardial segments and infarct LSpeak reduced significantly (P<0.01). TPSLs extended significantly. With the reperfusion time, the heart outside the infarct segment recovered gradually. TPSLS was shortened and after 3 months of the success of reperfusion therapy it returned to normal levels. Compared with the MI group and the non-infarct segments and the control group, there were statistically signification (P<0.05) after 3 to 7 days and 3 months of successful reperfusion therapy.3. Changes of infarction subendocardial infarction myocardial segments and the two-dimensional subepicardial myocardial strainFrom 3 to 7 days and 3 months of reperfusion before treatment after successful reperfusion therapy:Infarction subepicardial infracted myocardial segments LSpeak was higher than the subendocardial LSpeak (P<0.05) in the same period; infarction Festival TPSLS subepicardial myocardial segment TPSLS were lower than the subendocardial TPSLS (P<0.05) in the same period.4. Changes of myocardial infarction in the overall segment in two-dimensional strain.After 3 to 7 days successful reperfusion therapy, the whole floor of myocardial infarction LSpeak segments significantly reduced, TPSLS significantly extended, compared with before reperfusion therapy (P<0.05), with reperfusion extending, LSpeak increased gradually, and TPSLS shortened,3 months later recovered back to normal levels, comparing with before treatment of reperfusion(P>0.05).5. Changes of myocardial infarction in the overall segment of non-dimensional strain.After 3 to 7 days of successful reperfusion therapy, the whole layer of non-infarct segments ocardial LSpeak significantly increased. Comparing with before reperfusion therapy (P<0.05), TPSLS significantly shortened. With reperfusion extended, comparing with before reperfusion therapy (P<0.05), after 3 months it returned to normal levels.Conclusion1,With AMI, myocardial infarction myocardial infarction deformation segment weakened or even disappeared; subendocardial myocardium was more vulnerable than subepicardial myocardium.2,After successful reperfusion, Infarction of myocardial deformation segment enhanced, and even returned to normal leval; subepicardial myocardial was easier than subendocardial myocardial in functional recovery.3,AMI before reperfusion and after success of reperfusion, there were the mechanical changes between infarct segment subendocardial myocardium and epicardial cross-wall, the change can be found by measuring TPSLS and LSpeak with 2D-STI technology.