A.N. Parkhomenko, Ya.M. Lutai, A.A. Stepura.New possibilities for assessment of contraction geometry and early heart remodeling in patients with acute myocardial infarction: 2D speckle-tracking echocardiography.

Longitudinal and circumferential strain (S) and strain rate (SR) have been shown to be powerful predictors of outcome in patients with acute myocardial infarction (MI). We investigated the clinical value of these measures as predictors of early left ventricular (LV) dilatation in patients with acute MI. 76 patients with recent first Q-wave MI were investigated. 49 (64.5 %) pts had anterior MI. Echocardiography was performed during the first 24 hours (mean 14.6±1.4 hrs) after symptoms onset and 8 days after MI. Strain measurements were based on speckle tracking approach. Global longitudinal systolic S and SR were measured from standard apical 2-, 3- and 4-chambers views with circumferential S and SR from short-axis midwall view. Early LV dilatation was defined as at least 15 % increase of end-diastolic volume. Both longitudinal and circumferential S and SR were predictive of in-hospital acute heart failure development. 21 (27.6 %) pts had early LV dilatation. Circumferential S and SR were significantly reduced in patients with early post-MI LV dilatation, while there were no difference between groups in longitudinal S and SR. The level of CS > –11.0 % was predictive of early post MI LV dilatation development (sensitivity 78.3 %, specificity 73.1 %, P –8.4 % was predictive of acute heart failure development during acute phase of MI (sensitivity 75.0 %, specificity 80.6 %, P

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