P3502D longitudinal strain: does it match conventional echocardiographic parameters of left ventricle performance in acute myocardial infarction?

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Longitudinal strain is an useful echocardiographic parameter of regional and global LV performance, being described as independent from loading conditions.Aim: To assess the correlation between conventional echocardiographic parameters of LV function and longitudinal deformation in patients with acute myocardial infarction (AMI).Methods: Retrospective study of 77 patients (pts) without known coronary disease, 60 men, m=56.6±12.8y, with ST-elevation anterior myocardial infarction, submitted to primary percutaneous coronary intervention (PCI). A complete transthoracic echocardiogram was performed 3.7±1.9 days after the PCI. LV global longitudinal strain (GLS) was obtained from apical views and left anterior descending (LAD) coronary artery flow was also assessed. By Pearson's index, we correlated with GLS: LV ejection fraction (EF), volumes, wall motion score index (WMSI), E wave deceleration time, E/E', left atrium indexed volume, pulmonary artery systolic pressure, LAD flow characteristics (peak velocity and deceleration time).Results: The mean values of the analyzed parameters were: LV EF 47.8+-8.9%, end systolic volume 61.1+-38.9mL, wall motion score index (WMSI) 1.7+-0.3, E wave deceleration time (DT) 177.0+-47.7ms, E/E' 9.4+-3.8, indexed left atrium volume 29.2+-9.5mL/m2, LAD flow peak velocity 38.4+-20.5cm/s and deceleration time 444.4+-316.8ms. Mean 2D LV GLS was -11.0+-2.6%. Significant correlation was found between GLS and LVEF (r-0.717, p<0.001), WMSI (r0.623, p<0.001), ESV (r0.389, p=0.011), E/E' (r0.346, p=0.025) and LAD flow DT (r-0.392, p=0.014). LV GLS was strongly correlated with LV EF (graphic).Conclusion: LV performance after AMI assessed by longitudinal deformation follows not only LV EF and WMSI but also a filling pattern parameter (E/E') and a coronary perfusion index.

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