scholarly journals Role of speckle tracking echocardiography in patients with myocardial infarction

Pathologia ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 117-124
Author(s):  
A. V. Kobets ◽  
M. P. Kopytsia ◽  
N. V. Tytarenko ◽  
Yu. V. Rodionova

All over the world cardiovascular diseases are one of the main reason of morbidity and mortality in the structure of non-communicable diseases, and myocardial infarction has a leading role. Markers of modern advanced ultrasound techniques, speckle tracking echocardiography, play significant role in the detection and assessment of cardiovascular disease. Deviation of them can detect myocardial ischemia, hypertrophy, dystrophy and infiltration, severe systemic diseases, cardiotoxicity of the drugs, etc. This technology significantly improves diagnostic capabilities of transthoracic echocardiography, it allows to assess myocardial function in all three planes (longitudinal, circumferential and radial), in which myocardium moves during cardiac cycle. Speckle tracking echocardiography can determine the volume of myocardial damage, differentiate subendocardial and transmural myocardial infarction, identify viable and fibrous areas of the myocardium, that is confirmed by the results of magnetic resonance imaging. Besides, this method helps to detect and assess mechanical dyssynchrony and also predict the risk of pathological left ventricular remodeling and life-threatening adverse cardiovascular events (arrhythmias, increasing of heart failure, recurrent myocardial infarction, stroke, death, etc.), that is important for patients with acute myocardial infarction to identify high-risk patients. The most studied markers of this technique are longitudinal, circumferential and radial strain, mechanical dispersion and postsystolic shortening. Markers of this ultrasound technique significantly complete other markers of transthoracic echocardiography, such as left ventricular ejection fraction, to assess risk stratification of cardiovascular complications. The value of speckle-tracking echocardiography markers has been demonstrated alone or in combination with other markers.

2019 ◽  
Vol 4 (3) ◽  
pp. 120-123
Author(s):  
Ioana Cîrneală ◽  
Diana Opincariu ◽  
István Kovács ◽  
Monica Chițu ◽  
Imre Benedek

Abstract Heart failure is a clinical syndrome that appears as a consequence of a structural disease, and the most common cause of left ventricular systolic dysfunction results from myocardial ischemia. Cardiac remodeling and neuroendocrine activation are the major compensatory mechanisms in heart failure. The main objective of the study is to identify the association between serum biomarkers illustrating the extent of myocardial necrosis (highly sensitive troponin as-says), left ventricular dysfunction (NT-proBNP), and systemic inflammatory response (illustrated via serum levels of hsCRP and interleukins) during the acute phase of a myocardial infarction, and the left ventricular remodeling process at 6 months following the acute event, quantified via speckle tracking echocardiography. The study will include 400 patients diagnosed with acute myocardial infarction without signs and symptoms of heart failure at the time of enrollment that will undergo a complex clinical examination and speckle tracking echocardiography. Serum samples from the peripheral blood will be collected in order to determine the inflammatory serum biomarkers. After 6 months, patients will be divided into 2 groups according to the development of ventricular remodeling, quantified by speckle tracking echocardiography: group 1 will consist of patients with a remodeling index lower than 15%, and group 2 will consist of patients with a remodeling index higher than 15%. All clinical and imaging data obtained at the baseline will be compared between these two groups in order to determine the features associated with a higher risk of deleterious ventricular remodeling and heart failure.


2020 ◽  
Vol 14 ◽  
pp. 117954682093001
Author(s):  
Manal F Elshamaa ◽  
Fatma A Mostafa ◽  
Inas AES Sad ◽  
Ahmed M Badr ◽  
Yomna AEM Abd Elrahim

Background: Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE). Methods: Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE. Results: The LS was significantly reduced in pre-HD and post-HD patients compared with controls ( P = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls ( P < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments ( P = .035 and P = .013, respectively). Conclusion: Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.


Cardiology ◽  
2015 ◽  
Vol 132 (4) ◽  
pp. 233-241 ◽  
Author(s):  
Xiaoxia Liu ◽  
Yumei Dong ◽  
Song Chen ◽  
Guangde Zhang ◽  
Mingyu Zhang ◽  
...  

Objectives: MicroRNA (miR)-146a and miR-21 have been reported to participate in inflammatory reactions and fibrosis. Excessive inflammation and cardiac fibrosis may play important roles in the development of left ventricular remodeling (LVR). This study assessed whether miR-146a, miR-21 and other biomarkers could predict LVR after myocardial infarction (MI). Methods: Circulating miR-146a, miR-21 and other biomarker levels were measured in 198 patients with acute MI 5 days after primary percutaneous coronary intervention (PCI). All patients were assessed by transthoracic echocardiography on day 5 and 1 year after primary PCI. Results: Concentrations of circulating miR-146a, miR-21, C-reactive protein, creatine kinase MB type and troponin I, as well as estimated glomerular filtration rate (eGFR) and left ventricular ejection fraction (LVEF), were significantly higher in patients with than in those without LVR (p < 0.05). Multivariate logistic regression analysis showed that circulating miR-146a (odds ratio, OR = 2.127, p < 0.0001), miR-21 (OR = 1.119, p < 0.0001), eGFR (OR = 0.939, p = 0.0137) and LVEF (OR = 0.802, p = 0.0048) were independent predictors of LVR development. The area under the curve for the combination of miR-146a and miR-21 was significantly higher than for either alone. Conclusion: Circulating miR-146a and miR-21 may be novel biomarkers predictive of LVR after acute MI. Their combination may better predict LVR than either alone.


2021 ◽  
Vol 5 (4) ◽  
pp. 169-175
Author(s):  
E.G. Akramova ◽  
◽  
Е.V. Vlasova ◽  
◽  

Aim: to assess the results of speckle tracking echocardiography (STE) in patients of working age with acute inferior wall myocardial infarction (MI) in the early period after coronary stenting. Patients and Methods: STE was performed using EPIQ-7 Ultrasound Machine (Philips, USA) in 55 patients with acute inferior wall MI one week after percutaneous coronary intervention and 29 healthy individuals of working age. Patients with acute inferior wall MI were divided into two subgroups, i.e., with (n=45) or without (n=10) areas of local contractile impairment (dyskinesia, akinesia, hypokinesia). Results: the most common cause of MI was the occlusion of the right coronary artery (82.4% in subgroup 1 and 60% in subgroup 2) in multivascular involvement (84.4% and 90%. respectively). In patients with local contractile impairment, reduced left ventricular ejection fraction (EF) was reported in 28.9%, global longitudinal strain in 86.7%, and global circular strain in 76.7%. Meanwhile, in patients without local contractile impairment, left ventricular ejection fraction (LV EF) was within normal ranges, global longitudinal strain was reported in 100% and global circumferential strain in 70%. The presence and severity of local dysfunction did not affect the reduction in segmental strain (median varied from -9% to -15%). In inferior wall MI, the abnormal regional longitudinal strain of 6 LV segments (basal and mid inferoseptal, inferior, and inferolateral) was reported in both hypokinesia and normokinesia. Conclusions: ultrasound evaluation of systolic LV function using STE is characterized by greater diagnostic value compared to the measurement of EF only and objectifies the efficacy of surgery. Quantitative assessment of the recovery of both global and local systolic contractility is another advantage of STE allowing for personalized treatment. KEYWORDS: inferior wall myocardial infarction, echocardiography, speckle tracking technology, percutaneous coronary intervention, ejection fraction. FOR CITATION: Akramova E.G., Vlasova Е.V. Assessment of left ventricular contractility in acute inferior wall myocardial infarction by speckle tracking echocardiography. Russian Medical Inquiry. 2021;5(4):169–175 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-169-175.


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