scholarly journals Echocardiographic comparison of regional wall motion abnormality between patients with acute anteroseptal and acute extensive anteior ST segment elevation myocardial infarction

2016 ◽  
Vol 41 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Tunaggina Afrin Khan ◽  
Abdul Wadud Chowdhury ◽  
HI Lutfur Rahman Khan ◽  
M. Guffar Amin ◽  
Khandker Mohammed Nurus Sabah ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Wall Motion Abnormality ◽  
Wall Motion ◽  
Myocardial Damage ◽  
Regional Wall Motion ◽  
Regional Wall ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Regional Dysfunction

Post myocardial infarction (MI) short and long term clinical outcome is largely determined by the size of the infarcted area. It is generally assumed that as the lead involvement in electrocardiography (ECG) is less in anteroseptal ST segment elevation myocardial infarction (AS-STEMI), where ST segment elevation (STE) is limited to leads V1 to V3, myocardial damage is likely to be less; and in extensive anterior STEMI (EA-STEMI), as theSTE extends further upto V6, the myocardial damage is likely to be more. This study was intended to compare regional wall motion abnormality (RWMA) between acute anteroseptal STEMI and acute extensive anterior STEMI patients. 90 patients with AS-STEMI and 106 patients with EA-STEMI, admitted in between October 2012 and September 2013, were included. For each patient, a transthoracic echocardiogram (TTE) was performed within 24-48 hours of MI and was interpreted by an independent investigator blinded to the patient's ECG data. No differences were observed between the two groups in baseline characteristics; except AS-STEMI group had more patients with diabetes and EA-STEMI group had more patients with family history of coronary artery disease. Distribution, extent of wall motion abnormalities and mean number of total involved segments were similar between patients with AS-STEMI and those with EA-STEMI (p>0.05). Regarding regional dysfunction, the apical septal (99.1% vs. 92.2%, p<0.05) and apical (76.4% vs. 60.0%, p<0.05) segments were the only two segments that were affected significantly more in patients with EA-STEMI than in patients with AS-STEMI. So, the term AS-STEMI may be a misnomer, as it implies that only the anteroseptal segments of the left ventricle are involved. This study shows that regional dysfunction in patients with AS-STEMI extends beyond the anteroseptal region. So, any patients with anterior wall involvement, either anteroseptal or extensive anterior STEMI, should be treated with equal importance.

scholarly journals Assessment of Regional Wall Motion Abnormality in Patients with Acute Anteroseptal ST Segment Elevation Myocardial Infarction

2019 ◽  
Vol 15 (1) ◽  
pp. 28-33
Author(s):  
Tunaggina Afrin Khan ◽  
Saiful Ahmed ◽  
Mostashirul Haque ◽  
Md Rasul Amin ◽  
ATM Iqbal Hasan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricle ◽  
Wall Motion Abnormality ◽  
Wall Motion ◽  
Regional Wall Motion ◽  
Regional Wall Motion Abnormality ◽  
Regional Wall ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Post myocardial infarction (MI) short and long term clinical outcome is largely determined by the size of the infarcted area. It is generally assumed that as the lead involvement in the 12 lead electrocardiography (ECG) is less in anteroseptal ST segment elevation myocardial infarction (AS-STEMI), where ST segment elevation (STE) is limited to leads V1 to V3, myocardial damage is likely to be less. This study was intended to assess regional wall motion abnormality (RWMA) in acute anteroseptal STEMI patients. 90 patients with AS-STEMI admitted in between October 2012 and September 2013, were included. For each patient, a transthoracic echocardiogram (TTE) was performed within 24-48 hours of MI and was interpreted by an independent investigator blinded to the patient’s ECG data.The mean (± SD) age of the patients was 51.57 (± 12.02) years with mean (± SD) age of the patients was 52.58 (± 12.02) years with a range of 23 - 80 years. There were 91.1% male and 8.9% female. The mean (± SD) EF% was 38.80 %( ± 5.78). All the segments of left ventricle, except basal and mid inferolateral segments, were affected in anteroseptal STEMI. So, the term AS-STEMI may be a misnomer, as it implies that only the anteroseptal segments of the left ventricle are involved. This study shows that regional dysfunction in patients with AS-STEMI extends beyond the anteroseptal region and may be it is as much extensive as extensive anterior myocardial infarction. So, any patients with anterior wall involvement should be treated with utmost importance. University Heart Journal Vol. 15, No. 1, Jan 2019; 28-33

scholarly journals PANCREATITIS-INDUCED ACUTE ST SEGMENT ELEVATION AND REGIONAL WALL MOTION ABNORMALITY

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A199
Author(s):  
Prashank Neupane ◽  
Zed Seedat ◽  
Maryam Moghareh ◽  
Touqir Zahra
Keyword(s):  
Wall Motion Abnormality ◽  
Wall Motion ◽  
Regional Wall Motion ◽  
Regional Wall Motion Abnormality ◽  
Regional Wall ◽  
St Segment Elevation ◽  
St Segment

Cardiac MRI to Visualize Myocardial Damage after ST-Segment Elevation Myocardial Infarction: A Review of Its Histologic Validation

Radiology ◽  
2021 ◽  
pp. 204265
Author(s):  
Casper W. H. Beijnink ◽  
Nina W. van der Hoeven ◽  
Lara S. F. Konijnenberg ◽  
Raymond J. Kim ◽  
Sebastiaan C. A. M. Bekkers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Mri ◽  
Myocardial Damage ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

4936Cardiac magnetic resonance strain analysis predicts functional recovery following acute ST-segment elevation myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Valente ◽  
V Bodi ◽  
J Gavara ◽  
V Pineda ◽  
J Monmeneu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Functional Recovery ◽  
Predictive Value ◽  
Wall Motion ◽  
Strain Analysis ◽  
Contrast Administration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Tissue Tracking ◽  
St Segment

Abstract Background Late gadolinium enhancement (LGE) is the clinical reference standard for estimation of infarct extension and prediction of functional recovery following reperfused acute ST-segment elevation myocardial infarction (STEMI). Nevertheless, myocardial edema, microvascular obstruction and intramyocardial hemorrhage as well as the timing of image acquisition after contrast administration may influence the extent of LGE and underestimate the potential for recovery. Dobutamine stress testing has been recommended to more accurately predict functional recovery when infarct transmurality is between 25 to 75%. We hypothesized that cardiac magnetic resonance (CMR) tissue tracking strain analysis may provide additional value to LGE for the prediction of functional recovery. Methods In 370 patients with STEMI who underwent successful primary percutaneous revascularization and were studied with CMR within 3–5 days of the event, peak systolic longitudinal (LS), circumferential (CS) and radial (RS) strain were analyzed with routine SSFP images of 3 long-axis and a stack of short-axis slices (Tissue Tracking, CVI42®, Figure panel A and B). Inversion-recovery echogradient sequences were analyzed 20 minutes after contrast administration for LGE transmurality (Panel C). All per-segment analysis was performed according to the AHA 16-segment model. CMR was repeated at 6 months and functional recovery was defined as persistent normokinesia or improvement of wall motion score from baseline to 6-month CMR. Results At baseline CMR, of a total of 5920 segments 70.4% were normokinetic, 7.2% were hypokinetic, 21.9% were akinetic and 0.6% were dyskinetic. All strain parameters decreased significantly with worsening wall motion. At follow-up, 81.5% of the segments showed functional recovery. All strain parameters were significantly associated with functional recovery (p<0.001) and showed higher predictive value for improvement of wall motion than LGE transmurality (ROC AUC 0.713 LS, 0.710 CS, 0.683 RS and 0.660 LGE). For basal CMR dysfunctional segments, a CS <−10.7% showed the highest accuracy (66%) to predict wall motion improvement, with 58% sensitivity, 76% specificity, 75% positive predictive value (PPV) and 59% negative predictive value (NPV). These results were comparable to LGE transmurality <50% (65% accuracy, 59% sensitivity, 73% specificity, 74% positive predictive value and 58% negative predictive value). Nevertheless, adding CS analysis to a 50% LGE transmurality cutoff was the best combination for prediction of functional recovery and increased the overall accuracy to 70%, with 76% sensitivity, 64% specificity, 65% PPV and 75% NPV. CS analysis in an inferior STEMI Conclusions Acute CMR tissue tracking strain analysis complements LGE assessment for prediction of functional recovery following an STEMI. The combination of LGE infarct transmurality under 50% and a CS strain higher than −10.7% showed the highest accuracy for prediction of recovery of function.

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