Quantitative two-dimensional echocardiographic analysis of regional wall motion in patients with perioperative myocardial infarction.

The aims of this study were to assess the sequential changes of left ventricular (LV) systolic and diastolic synchronicity in patients with acute myocardial infarction (AMI) and to assess their relation with LV recovery and remodeling. Forty-patients with acute ST-elevation MI were examined within 2days, 6weeks and 6months after primary coronary intervention. Fifteen-age matched subjects were enrolled for normal control. The time from the onset of QRS complex to peak systolic velocity (Ts) and to peak early diastolic velocity (Te) were measured on color-coded tissue Doppler imaging. To assess LV synchronicity, SDs of Ts (Ts-SD) and Te (Te-SD) of all 12 segments were calculated (within 2days, at 6weeks and 6months; SD1, SD2 and SD3, respectively). LV recovery was defined as the improvement of wall motion at least more than two segments at 6 weeks. In all AMI patients, the wall motion score index was 1.72±0.27 and LV ejection fraction was 45.9±9.9%. The Ts-SD1 was higher in AMI patients than in controls (45.4±13.5 vs 29.4±13.3ms, p<0.05), but Te-SD1 was not different (18.7±6.9 vs 16.2±10.0). Twenty-two patients (group1) showed a recovery and 18 patients (group2) showed no recovery. The Ts-SD1 was smaller in group1 than in group2 (43.4±12.6 vs 47.9±11.7 ms, p<0.05). In group1, Ts-SD were much decreased as follow up (Ts-SD2, 3; 36.6±14.0 and 31.1±9.5, respectively, p<0.05). In contrast, in group2, Ts-SD was not significantly changed (Ts-SD2,3; 46.7±13.2 and 43.7±8.8, respectively) but Te-SD was increased as follow up (Te-SD1,2,3; 17.8±5.5, 20.4±4.3 and 25.0±3.8, respectively, p<0.05). The LV end-diastolic and systolic volume were increased and the deceleration time of early diastolic mitral inflow velocity was shortened in group2 (p<0.05). This clinical study shows: 1) in acute phase, the regional wall motion abnormalities of AMI had an impact on LV systolic synchronicity; 2) the AMI patients with LV recovery showed better LV systolic synchronicity; 3) the LV systolic synchronicity became better as regional wall motion was improved; and 4) in chronic phase, the LV diastolic synchronicity became worse in AMI patients with no recovery, which might be related to LV remodeling and worsening of LV diastolic function.

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Echocardiographic assessment of left ventricular function in patients of acute myocardial infarction

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20173070 ◽

2017 ◽

Vol 4 (4) ◽

pp. 926

Author(s):

Anjali V. Shivpuje ◽

Shrikant Page

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Wall Motion ◽

Health Centre ◽

Regional Wall Motion ◽

Left Ventricular ◽

Lv Function ◽

Regional Wall ◽

Wall Motion Abnormalities ◽

Echocardiographic Assessment

Background:2D Echo can evaluate LV anatomy, function and diagnose post AMI complications in early stages, thus help in management and determining the prognosis. The present study was undertaken to evaluate LV function in patient following AMI and also to find out the incidence of various echocardiographically detectable complications of following AMI.Methods: The present study was conducted on patients visiting our tertiary health centre during study duration. 50 patients were included in the study. Patients with prior history of acute myocardial infarction, pericarditis and early repolarisation syndrome, and primary myocardial disease diagnosed by serum enzyme levels were not included in the study. Patients were classified as per Killip classification and 2D echo study was performed in all patients.Results: Maximum incidence of AMI was found in 51-60 years of age, with male predominance (64%). Anterior wall AMI (58%) was more common. 94% of patients had wall motion abnormalities. Incidence of LV thrombus was found to be 24%. In present study, as the extent and severity of wall motion abnormalities increased, the incidence of LV thrombus also increased. Thus, 2DE study of LV regional wall motion can predict the incidence of LV thrombus.Conclusions: The echocardiographic assessment of LV function in patients of AMI is important as, it detects the regional wall motion abnormality, LVEF and also the complications like LV thrombus, pericardial effusion and LV aneurysm. These observations are of great value in the management of AMI.

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Quantitative evaluation of left ventricular regional wall motion using a real-time wall thickness curve system with two-dimensional echocardiography

The American Journal of Cardiology ◽

10.1016/s0002-9149(99)00535-4 ◽

1999 ◽

Vol 84 (10) ◽

pp. 1204-1208 ◽

Cited By ~ 4

Author(s):

Katsufumi Mizushige ◽

Wataru Furumoto ◽

Kenichi Hirao ◽

Yasuyoshi Iwado ◽

Koji Ohmori ◽

...

Keyword(s):

Real Time ◽

Quantitative Evaluation ◽

Wall Thickness ◽

Wall Motion ◽

Regional Wall Motion ◽

Left Ventricular ◽

Two Dimensional ◽

Regional Wall ◽

Dimensional Echocardiography ◽

Two Dimensional Echocardiography

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Editor’s Choice- Pathophysiology, diagnosis and management of MINOCA: an update

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872618782414 ◽

2018 ◽

Vol 8 (1) ◽

pp. 54-62 ◽

Cited By ~ 36

Author(s):

Giancarla Scalone ◽

Giampaolo Niccoli ◽

Filippo Crea

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Coronary Arteries ◽

Wall Motion ◽

Regional Wall Motion ◽

Left Ventricular ◽

Regional Wall ◽

Diagnosis And Management ◽

Regional Wall Motion Abnormalities ◽

Wall Motion Abnormalities

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a syndrome with different causes, characterised by clinical evidence of myocardial infarction with normal or near-normal coronary arteries on angiography. Its prevalence ranges between 5% and 25% of all myocardial infarction. The prognosis is extremely variable, depending on the cause of MINOCA. The key principle in the management of this syndrome is to clarify the underlying individual mechanisms to achieve patient-specific treatments. Clinical history, electrocardiogram, cardiac enzymes, echocardiography, coronary angiography and left ventricular angiography represent the first level diagnostic investigations to identify the causes of MINOCA. Regional wall motion abnormalities at left ventricular angiography limited to a single epicardial coronary artery territory identify an ‘epicardial pattern’whereas regional wall motion abnormalities extended beyond a single epicardial coronary artery territory identify a ‘microvascular pattern’. The most common causes of MINOCA are represented by coronary plaque disease, coronary dissection, coronary artery spasm, coronary microvascular spasm, Takotsubo cardiomyopathy, myocarditis, coronary thromboembolism, other forms of type 2 myocardial infarction and MINOCA of uncertain aetiology. This review aims at summarising the diagnosis and management of MINOCA, according to the underlying physiopathology.

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