Automated Assessment of Myocardial Viability After Acute Myocardial Infarction by Global Longitudinal Peak Strain on Low-Dose Dobutamine Stress Echocardiography

作者：Iwakura Katsuomi^*; Okamura Atsushi; Koyama Yasushi; Date Motoo; Higuchi Yoshiharu; Inoue Koichi; Kimura Ryusuke; Nagai Hiroyuki; Imai Michio; Toyoshima Yuko; Ozawa Makito; Ito Norihisa; Okazaki Yukinori; Shibuya Masahiko; Omiya Shigemiki; Takagi Takashi; Morisawa Daisuke; Fujii Kenshi

来源：Circulation Journal, 2010, 74(10): 2158-2165.

DOI：10.1253/circj.CJ-10-0239

• Acute myocardial infarction
• Echocardiography
• Myocardial contraction
• Stress

Background: Low-dose dobutamine stress echocardiography (DSE) assesses myocardial viability at the early stage of acute myocardial infarction (AMI), but its assessment is subjective and variable. Automated function image (AFI) determines global longitudinal peak strain (GLPS) based on tissue tracking technique. The ability of GLPS obtained by AFI during dobutamine stress to assess myocardial viability after AMI was investigated.
Methods and Results: Low-dose DSE at day 3 in 23 consecutive patients with AMI was performed using Vivid 7 (GE Healthcare). Segmental longitudinal peak strain with AFI and obtained GLPS was analyzed. Wall motion score index (WMSI) by echocardiography 1 month later was determined. In 18 patients, left ventriculography was also performed at 3.2 +/- 1.5 months later to obtain left ventricular ejection fraction (LVEF) and regional wall motion (RWM, SD/chord). GLPS was improved during dobutamine infusion at 10 mu g.kg(-1).min(-1) (-12.9 +/- 3.5% to -15.2 +/- 3.6%, P=0.0004). GLPS during dobutamine stress showed good correlations with follow-up WMSI (R=0.47, P=0.02), with peak CK-MB (R=0.52, P=0.01), with RWM (R=-0.48, P=0.04), and with LVEF (R=-0.54, P=0.02), whereas GLPS at baseline showed no correlations with them. Averaged segmental peak strain at baseline and during stress were correlated with follow-up WMSI (R=0.50 and 0.43, respectively), but not with LVEF.
Conclusions: GLPS during dobutamine stress determined by AFI is a promising, objective index to assess myocardial viability on the early stage of AMI. (Circ J 2010; 74: 2158-2165)

• 出版日期2010-10