Speckle Tracking Imaging In Evaluating Of Left Ventricular Remodeling After Acute Anterior Myocardial Infarction In Patients With Preserved Ejection Fraction

Objective We investigated whether Two-dimensional Speckle Tracking Imaging(STI)technique could evaluate Left Ventricular Remodeling after Acute Anterior Myocardial Infarction in patients with Preserved Ejection Fraction.Methods Fifty patients who were Acute Anterior Myocardial Infarction with Preserved Ejection Fraction were examined by echocardiography immediately after admission.After 6 months,the patients were divided into two groups according to the presence or absence of Left Ventricular Remodeling.The apical 2 chambers,3chambers,4 chambers,long axis views of two-dimensional imaging were acquired immediately after admission and in 6th month after Percutaneous Coronary Intervention(PCI).Longitudinal Peak Systolic Strain Rate(LS),Longitudinal Peak Systolic Strain Rate(LSR),Global Longitudinal Strain(GLS),Global Longitudinal Strain Rate(GLSR),Injured Longitudinal Strain(Inj LS),Injured Longitudinal Strain Rate(Inj LSR)were calculated for left ventricular segments by Two-dimensional Strain workstation.Left Ventricular End Diastolic Volume(LVEDV),Left Ventricular End Systolic Volume(LVESV),Left Ventricular Ejection Fraction(LVEF),Ventricular Wall Motion Score Index(WMSI),Peak Early Wave Velocity /Peak Early Diastolic Velocity At Mitral Septum(E/e')were calculated by echocardiography.To analysis relationship between left ventricular echocardiographic parameters(LVESV,LVEDV,LVEF,WMSI,E/e')and two dimensional strain parametres(LS,LSR,Inj LS,Inj LSR)in remodeling group.Global Longitudinal Strain(GLS),Global Longitudinal Strain Rate(GLSR),Injured Longitudinal Strain(Inj LS),Injured Longitudinal Strain Rate(Inj LSR)were analyzed by ROC curve.Results Increased percentage of Left Ventricular End Systolic Volume(?LVESV%),increased percentage of Left Ventricular End Diastolic Volume(?LVEDV%),WMSI,E/e' values were significantly different between the Left Ventricular Remodeling group and the Non-left Ventricular Remodeling group,P<0.05.The Longitudinal Peak Systolic Strain was positively correlated with LVEF(r= 0.96,P<0.01).The Global Longitudinal Strain Rate was positively correlated with LVEF(r = 0.97,P <0.01).The Injured Longitudinal Strain(Inj LS)was positively correlated with LVEF(r = 0.81,P <0.01),The Injured Longitudinal Strain Rate(Inj LSR)was positively correlated with LVEF(r = 0.95,P<0.01).Global Longitudinal Strain(GLS)?-14%,the diognosis sensitivity and specificity of Left Ventricular Remodeling after Acute Anterior Myocardial Infarction in patients with Preserved Ejection Fraction were 88.2% and 87.9%,Global Longitudinal Strain Rate?-1.1 S-1,the sensitivity and specificity were 94.1% and 42.4%.Injured Longitudinal Strain ?-11%,the diognosis sensitivity and specificity of Left Ventricular Remodeling after Acute Anterior Myocardial Infarction in patients with Preserved Ejection Fraction were 88.2% and 63.6%,Injured Longitudinal Strain Rate?-1.1S-1,the diognosis sensitivity and specificity of Left Ventricular Remodeling after Acute Anterior Myocardial Infarction in patients with Preserved Ejection Fraction were 88.2% and 69.7%.Conclusion(1)Speckle Tracking Imaging can initially assess left ventricular deformation,myocardial local and overall function of left ventricular deformation,myocardial local and overall function for Left Ventricular Remodeling after Acute Anterior Myocardial In farctionin patients with Preserved Ejection Fraction,also there were good correlations between two dimensional strain parameters and Left Ventricular Remodeling indicators.(2)Speckle Tracking Imaging techniques can be used as a quantitative predictor of Left Ventricular Remodeling after Acute Anterior Myocardial Infarctionin patients with Preserved Ejection Fraction and clinical prognosis to provide important predictive information.(3)Combined with Global Longitudinal Strain(GLS),Injured Longitudinal Strain(Inj LS),Injured Longitudinal Strain Rate(Inj LSR)can better predict for Left Ventricular Remodeling after Acute Anterior Myocardial Infarction in patients with Preserved Ejection Fraction.