Ai Kozuma1, Toshihiko Asanuma2, Kasumi Masuda1, Hitomi Adachi1, Seina Minami1, Satoshi Nakatani1. 1. Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Japan. 2. Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: toshi@sahs.med.osaka-u.ac.jp.
Abstract
BACKGROUND: Persistence of subtle abnormal myocardial deformation such as postsystolic shortening (PSS) after transient ischemia can be used to diagnose a history of myocardial ischemia (myocardial ischemic memory). Furthermore, early systolic lengthening (ESL) has recently attracted attention as another marker of myocardial ischemia. However, it is unclear whether the persistence of such abnormal deformation can be detected by three-dimensional (3D) speckle-tracking echocardiography, which has relatively low spatial and temporal resolution compared with two-dimensional echocardiography. The aim of this study was to evaluate the diagnostic accuracy of myocardial ischemic memory and its spatial extent using 3D speckle-tracking echocardiography. METHODS: The left circumflex coronary artery was occluded for 2 min, followed by reperfusion, in 33 dogs. Their hemodynamic and 3D echocardiographic data were chronologically acquired. Peak systolic strain, early systolic strain index as a parameter of ESL, postsystolic strain index as a parameter of PSS, and myocardial dysfunction index as a combined parameter of ESL and PSS were analyzed in all left ventricular segments. RESULTS: At the center of the risk area, early systolic strain index and postsystolic strain index significantly increased until 20 min after reperfusion compared with baseline, although peak systolic strain recovered by 20 min. Myocardial dysfunction index significantly increased for >20 min after reperfusion and allowed better diagnostic accuracy of ischemic memory than the other parameters. In the 147 risk segments, abnormal values of myocardial dysfunction index remained in 49 segments (33%) at 20 min after reperfusion, whereas abnormal peak systolic strain was observed in only 13 segments (9%). CONCLUSIONS: ESL and PSS persisted after transient ischemia and could be detected by 3D speckle-tracking echocardiography. Integrated analysis of ESL and PSS provided higher diagnostic accuracy of ischemic memory. This method may be useful for detecting transient ischemic insults in patients after the disappearance of anginal attack.
BACKGROUND: Persistence of subtle abnormal myocardial deformation such as postsystolic shortening (PSS) after transient ischemia can be used to diagnose a history of myocardial ischemia (myocardial ischemic memory). Furthermore, early systolic lengthening (ESL) has recently attracted attention as another marker of myocardial ischemia. However, it is unclear whether the persistence of such abnormal deformation can be detected by three-dimensional (3D) speckle-tracking echocardiography, which has relatively low spatial and temporal resolution compared with two-dimensional echocardiography. The aim of this study was to evaluate the diagnostic accuracy of myocardial ischemic memory and its spatial extent using 3D speckle-tracking echocardiography. METHODS: The left circumflex coronary artery was occluded for 2 min, followed by reperfusion, in 33 dogs. Their hemodynamic and 3D echocardiographic data were chronologically acquired. Peak systolic strain, early systolic strain index as a parameter of ESL, postsystolic strain index as a parameter of PSS, and myocardial dysfunction index as a combined parameter of ESL and PSS were analyzed in all left ventricular segments. RESULTS: At the center of the risk area, early systolic strain index and postsystolic strain index significantly increased until 20 min after reperfusion compared with baseline, although peak systolic strain recovered by 20 min. Myocardial dysfunction index significantly increased for >20 min after reperfusion and allowed better diagnostic accuracy of ischemic memory than the other parameters. In the 147 risk segments, abnormal values of myocardial dysfunction index remained in 49 segments (33%) at 20 min after reperfusion, whereas abnormal peak systolic strain was observed in only 13 segments (9%). CONCLUSIONS: ESL and PSS persisted after transient ischemia and could be detected by 3D speckle-tracking echocardiography. Integrated analysis of ESL and PSS provided higher diagnostic accuracy of ischemic memory. This method may be useful for detecting transient ischemic insults in patients after the disappearance of anginal attack.
Authors: Varius Dannenberg; Finn Christiansen; Matthias Schneider; Stefan Kastl; Thomas Martin Hofbauer; Thomas Scherz; Julia Mascherbauer; Dietrich Beitzke; Christoph Testori; Irene Marthe Lang; Andreas Mangold Journal: Clin Cardiol Date: 2021-06-12 Impact factor: 2.882
Authors: Philip Brainin; Sune Haahr-Pedersen; Flemming Javier Olsen; Anna Engell Holm; Thomas Fritz-Hansen; Thomas Jespersen; Gunnar Gislason; Tor Biering-Sørensen Journal: J Am Heart Assoc Date: 2020-01-24 Impact factor: 5.501
Authors: Philip Brainin; Søren Lindberg; Flemming J Olsen; Sune Pedersen; Allan Iversen; Søren Galatius; Thomas Fritz-Hansen; Gunnar Gislason; Peter Søgaard; Rasmus Møgelvang; Tor Biering-Sørensen Journal: Int J Cardiol Heart Vasc Date: 2021-05-28