New Marker of Early Cardiac Remodeling in Patients with Acute Myocardial Infarction with ST Elevation

A.N. Parkhomenko, Ya.M. Lutay, A.A. Stepura, О.I. Irkin


The study evaluated the parameters of myocardial deformation of the left ventricle (LV) to identify patients at high risk of early post-infarction LV dilation. We examined 76 patients with a first acute Q myocardial infarction within the first 24 hours of developing symptoms of the disease. Indicators of longitudinal, radial and circular LV deformation were evaluated using speckle-tracking echocardiography. Early post-infarction LV cavity dilation (increase in end-diastolic volume by 15 % or more) was diagnosed in 21 (27.6 %) patients. This category of patients already in the first day of the disease had a violation of the circular LV function, but in terms of the longitudinal and radial strain did not differ from patients without pathological remodeling. The value of the circular deformation > –11.0 % with a sensitivity of 78.3 % and specificity of 73.1% was a predictor of early pathologic LV remodeling. Using LV longitudinal strain parameters we identified patients with a high probability of acute heart failure in the hospital period of the disease.


speckle-tracking echocardiography; left ventricular deformation; acute myocardial infarction; strain; early post-stroke dilatation of the left ventricle; acute heart failure


Amundsen B.H., Helle-Valle T., Edvardsen T. et al. Noninvasive myocardial strain measurement by speckle tracking echocardiography: validation against sonomicrometry and tagged magnetic resonance imaging // J. Am. Coll. Cardiol. — 2006. — Vol. 47. — P. 789-793.

Brown J., Jenkins C., Marwick T. Use of myocardial strain to assess global left ventricular function: a comparison with cardiac magnetic resonance and 3-dimensional echocardiography // Am. Heart J. — 2009. — Vol. 157. — P. 102e1-102e5.

Blessberger H., Binder T. Non-invasive imaging: two dimensional speckle tracking echocardiography — basic principles // Heart. — 2010. — Vol. 96. — P.716-722.

D’Hooge J., Heimdal A., Jamal F. et al. Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations // Eur. J. Echocardiogr. — 2000. — Vol. 1(3). — P. 154-70.

Voigt J.U., Flachskampf F.A. Strain and strain rate. New and clinically relevant echo parameters of regional myocardial function // Z. Kardiol. — 2004. — Vol. 93. — P. 249-58.

Hurlburt H.M., Aurigemma G.P., Hill J.C. et al. Direct ultrasound measurement of longitudinal, circumferential, and radial strain using 2-dimensional strain imaging in normal adults // Echocardiography. — 2007. — Vol. 24. — P. 723-31.

Dandel M., Lehmkuhl H., Knosalla C. et al. Strain and strain rate imaging by echocardiography: basic concepts and clinical applicability // Curr. Cardiol. Rev. — 2009. — Vol. 5. — P. 133-148.

Marwick T.H., Leano R.L., Brown J. et al. Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography: definition of normal range // JACC Cardiovasc. Imaging. — 2009. — Vol. 2. — P. 80-4.

Takeuchi M., Otsuji Y., Lang R.M. Evaluation of left ventricular function using left ventricular twist and torsion parameters // Curr. Cardiol. Rep. — 2009. — Vol. 11. — P. 225-230.

Notomi Y., Lysyansky P., Setser R.M. et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging // J. Am. Coll. Cardiol. — 2005. — Vol. 45. — P. 2034-2041.

Notomi Y., Popovic Z.B., Yamada H. et al. Ventricular untwisting: a temporal link between left ventricular relaxation and suction // Am. J. Physiol. Heart Circ. Physiol. — 2008. — Vol. 294. — P. 505-513.

Greenbaum R.A., Ho S.Y., Gibson D.G. et al. Left ventricular fibre architecture in man // Br. Heart J. — 1981. — Vol. 45. — P. 248-263.

Yu C.M., Lin H., Yang H. et al. Progression of systolic abnormalities in patients with isolated diastolic heart failure and diastolic dysfunction // Circulation. — 2002. — Vol. 105. — P. 1195-1201.

Wang J., Khoury D.S., Yue Y. et al. Preserved left ventricular twist and circumferential deformation, but depressed longitudinal and radial deformation in patients with diastolic heart failure // Eur. Heart J. — 2008. — Vol. 29. — P. 1283-1289.

Hashimoto I., Li X., Hejmadi Bhat A. et al. Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue Doppler imaging // J. Am. Coll. Cardiol. — 2003. — Vol. 42. — P. 1574-1583.

Mizuguchi Y., Oishi Y., Miyoshi H. et al. The functional role of longitudinal, circumferential, and radial myocardial deformation for regulating the early impairment of left ventricular contraction and relaxation in patients with cardiovascular risk factors: a study with two-dimensional strain imaging // J. Am. Soc. Echocardiogr. — 2008. — Vol. 21. — P. 1138-1144.

Lang R.M., Bierig M., Devereux R.B. et al. Recommendations for chamber quantification // Eur. J. Echocardiography. — 2006. — Vol. 7. — P. 79-108.

Шиллep H., Оcипoв M.A. Kлиническaя эxoкapдиoгpaфия. — 2-e изд. — М.: Пpaктикa, 2005. — С. 62-73.

Urheim S., Edvardsen T., Torp H. et al. Myocardial strain by Doppler echocardiography: validation of a new method to quantify regional myocardial function // Circulation. — 2000. — Vol. 102. — P. 1158-64.

Langeland S., D’hooge J., Wouters P.F. et al. Experimental validation of a new ultrasound method for the simultaneous assessment of radial and longitudinal myocardial deformation independent of insonation angle // Circulation. — 2005. — Vol. 112. — P. 2157-2162.

Hashimoto I., Li X., Hejmadi Bhat A. et al. Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue Doppler imaging // J. Am. Coll. Cardiol. — 2003. — Vol. 42. — P. 1574-1583.

Zhang Y., Chan A.K., Yu C.M. et al. Strain rate imaging differentiates transmural from non-transmural myocardial infarction a validation study using delayed-enhancement magnetic resonance imaging // J. Am. Coll. Cardiol. — 2005. — Vol. 46. — P. 864-871.

Chan J., Hanekom L., Wong C. et al. Differentiation of subendocardial and transmural infarction using two-dimensional strain rate imaging to assess short-axis and long-axis myocardial function // J. Am. Coll. Cardiol. — 2006. — Vol. 48. — P. 2026-2033.

Zhang Q., Fung J.W., Yip G.W. et al. Improvement of left ventricular myocardial short-axis, but not long-axis function or torsion after cardiac resynchronisation therapy: an assessment by two-dimensional speckle tracking // Heart. — 2008. — Vol. 94. — P. 1464-1471.

Park T.H., Nagueh S.F., Khoury D.S. et al. Impact of myocardial structure and function postinfarction on diastolic strain measurements: implications for assessment of myocardial viability // Am. J. Physiol. Heart Circ. Physiol. — 2006. — Vol. 290. — P. 724-731.

Stanton T., Leano R., Marwick T.H. Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring // Circ. Cardiovasc. Imaging. — 2009. — Vol. 2. — P. 356-364.

Hung C.L., Verma A., Uno H. et al. Longitudinal and Circumferential Strain Rate, Left Ventricular Remodeling, and Prognosis After Myocardial Infarction // JACC. — 2010. — Vol. 56, № 22. — P. 1812-22.

Zaliaduonyte-Peksiene D., Vaskelyte J.J., Mizariene V. et al. Does Longitudinal Strain Predict Left Ventricular Remodeling after Myocardial Infarction? // Echocardiography. — 2012. — Vol. 29. — P. 419-427.

D’Andrea A., Cocchia R., Caso P. et al. Global longitudinal speckle-tracking strain is predictive of left ventricular remodeling after coronary angioplasty in patients with recent non-ST elevation myocardial infarction // International Journal of Cardiology. — 2011. — Vol. 153 (2). — P.1 85-191.

Park Y.H., Kang S.J., Song J.K. et al. Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction // J. Am. Soc. Echocardiogr. — 208. — Vol. 21. — P. 262-267.

Pfeffer M.A., Braunwald E. Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications // Circulation. — 1990. — Vol. 81. — P. 1161-1172.

Rohde L.E., Aikawa M., Cheng G.C. et al. Echocardiography-derived left ventricular end-systolic regional wall stress and matrix remodeling after experimental myocardial infarction // J. Am. Coll. Cardiol. — 1999. — Vol. 33. — P. 835-842.



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