V.M. Kovalenko, O.G. Nesukai, N.S. Polenova, O.O. Danylenko, Ye.Yu. Titov.Role of speckle-tracking echocardiography for assessment of the myocardial viability after Q-wave myocardial infarction.

Purpose of the research was to estimate the role of speckle-tracking echocardiography (STE) for assessment of the myocardial viability during dobutamine stress echocardiography (DSE). We studied 15 patients with ischemic heart disease who underwent DSE for assessment of myocardial viability. 83 segments with abnormal resting function and 32 segments without wall motion abnormality were analyzed. studied resting and low-dose dobutamine longitudinal end-systolic strain (ESS), longitudinal peak systolic strain (PSS), longitudinal peak systolic strain rate (SR) and post-systolic shortening (pSS). An increase of SR from rest to dobutamine stimulation by more than 0.4 c–1 allowed accurate discrimination of viable and nonviable myocardium, as determined by DSE. Viable segments also showed an increase of PSS by more than 4,0 %. pSS was characteristic for segments with rest wall motion abnormality, regardless of their viability. We have found decreasing pSS of viable segments at low dose dobutamine from 13.8±2.5 % to 8.4±1.7 %, while pSS of nonviable segments value remained almost unchanged – 22.5±3.0 % at rest and 19.9±2.6 % at low dose dobutamine. In conclusion, segmental analysis by longitudinal SR, ESS, PSS and pSS derived from STE offers diagnostic information about viability that is incremental to standard visual wall motion analysis.

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