The prediction of left ventricular myocardial viability in patients after myocardial infarction by real time three-dimensional speckle tracking imaging combined with real time myocardial contrast echocardiogra-phy:a clinical study
LI Yun
LI Hua
HU Jie
Abstract：Objective The aim of the present study was to investigate the value of predicting on the left ventricular myocardial viability in patients after myocardial infarction by real time three-dimensional speckle track-ing imaging(RT-3D-STI)combined with real time myocardial contrast echocardiography(RT-MCE). Methods 25 patients diagnosed with myocardial infarction by ECG,myocardial enzymes and coronary angiography and success-fully provided with coronary revascularization were recruited. Before revascularization,semi-quantitative evaluation of myocardial perfusion were determined by RT- MCE. After 6 months of follow-up,the patients were grouped into viable myocardium group and non-viable myocardium group based on whether having myocardial segmental wall mo-tion improvement or not after revascularization. Before and after revascularization,longitudinal peak strain(3D-GLPS),circumferential peak strain(3D-GCPS),radial peak strain(3D-GRPS)and area peak strain(3D-GAPS) by RT-3D-STI were measured for functional analysis. Results Before revascularization,3D-PLS,3D-PAS,3D-PCS,3D-PRS in myocardial viability group were significantly higher than those of non-viable myocardium group (P<0.05);the single parameter mode of ROC curve analysis showed that at resting state,the cutoff value of 3D-PAS which can assess myocardial viability was less than -16.5%,with a significantly higher AUC(0.944),sensi-tivity(91.3%),specificity(93.8%)than the other strains;the single technology mode of ROC curve analysis showed that 4D-SI had a AUC(0.969),sensitivity(95.7%)and specificity(90.6%). Before revascularization,the sensitivity and specificity of RT-MCE in assessing myocardial viability were 93.1% and 68.8%,the Kappa value was 0.645. Conclusion At resting state,RT-3D-STI has a higher value to predict myocardial viability after my-ocardial infarction than RT-MCE,among the three-dimensional strain parameters the cutoff value of 3D-PAS which can assess myocardial viability determines the highest value,and the combination of these two techniques is a more comprehensive method to assess myocardial viability.
Keywords：Three-dimensional speckle trackingStrainMyocardial contrast echocardiographyMy-ocardial infarctionRevascularizationMyocardial viability
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 314-318,后插1 )