Quantification of Regional Wall Motion Abnormality Using Myocardial Strain in Acute Myocardial Infarction

Cho, Goo Yeong; Park, Woo Jung; Han, Sung Woo; Han, Sang Jin; Choi, Seung Hyuk; Choi, Yung Jin; Doo, Young Cheoul; Han, Kyoo Rok; Lee, Nam Ho; Oh, Dong Jin; Ryu, Kyu Hyung; Rhim, Chong Yun; Lee, Yung

Abstract

BACKGROUND AND OBJECTIVES
Several echocardiographic methods, such as ejection fraction, fractional shortening, and Doppler tissue imaging (DTI), have been developed to quantify systolic function but all had several important limitations. The purpose of this study was to quantify the regional wall motion abnormality, using strain, in an acute myocardial infarction, compared with a visual estimation. SUBJECTS AND MEHTODS: Forty-five patients, with acute anterior (n=28) and inferior myocardial (n=17) infarctions, who underwent color DTI, were examined using longitudinal strain and standard echocardiography, and the results were compared with 54 normal controls. A total of 594 segments [3 segments (apical, mid and basal portion) of septum and inferior wallx99 patients] were evaluated.
RESULTS
In the normal control group, the strain was uniformly distributed in all segments (-20%~-23%). In the infarction groups, the strain was negatively related with the wall motion score. The strain of the apical segments and mid-septum was decreased in the anterior wall infarctions, and the strain of basal septum and mid to basal inferior wall was decreased in the inferior wall infarctions. The dyskinetic segments showed positive strain.
CONCLUSION
This study validates strain as a superior method for the quantification of the regional wall motion abnormality in an acute myocardial infarction than visual estimation.