Three-dimensional Speckl Tracking Echocardiography In The Evaluation Of Infarction Size In Patients With Recent Myocardial Infarction:a Comparison With Single Photon Emission Computed Tomography

Objective To compare three dimensional speckle tracking echocardiography with Single Photon emission computed tomography for evaluating of myocardial infarction size, to confirm the clinical value of three-dimensional myocardial strain in diagnosis of myocardial infarction size.Methods32patients after MI3-6months, underwent routine echocardiography、3D-STI and SPECT. Correlation analysis of3D area strain and longitudinal strain and SPECT in detecting myocardial infarction size. And application of ROC curve to evaluate three-dimensional myocardial strain detection myocardial infarction size value.Results According to the size of myocardial infarction by SPECT detection, these patients were invided into three groups.3D area strain and longitudinal strain in patients of the three groups were statistically differences, with the expansion of myocardial infarction size,3D area strain(3D-GAS) and longitudinal strain(3D-GLS) decreased. Analysis of correlation between global and local3D myocardial strain and MIA showed the correlation between3D-GAS^3D-GLS and Extent was the better (r=0.718, P=0.001;r=0.711, P=0.001). The best correlation between anterior wall3D-AS、3D-LS and Extent (r=0.733; r=0.556). ROC curve showed the3D strain indices, LVEF and WMSI could distinguish between MIs of different infarct sizes (P<0.01),3DGLS had the highest diagnostic value, showed a Cut-Off value of-12.06%with a sensitivity of81.3%and a specificity of71.6%for identification of LV infarct size>30%, The3D strain indices have good correlations to LVEF, the best correlations was3DGAS(r=0.781;P<0.01); And with mutle, only AS in lateral wall correlated with LVEF singnificantly. Conclusion The evaluation of myocardial infarction size by three-dimensional strain has good clinical application value, GLS correlated high with MIA, GAS correlated high with LVEF Objective:To compare three-dimensional (3D) and two-dimensional (2D) speckle tracking echocardiography (STE) for measuring myocardial strain to evaluate myocardial infarction area (MIA), using Single Photon emission computed tomography (SPECT) as a reference method, to confirm the clinical value of the two kinds of myocardial strain methods in diagnosis of myocardial infarction size.Methods:32patients after acute myocardial infarction3-6months, underwent routine echocardiography and SPECT. Echocardiography was also performed on18healthy controls.3D speckle tracking-based global area strain(GAS), global longitudinal strain(GLS), global radial strain(GRS), global circumferential strain(GCS), Left ventricular ejection fraction (LVEF) by3D echocardiography,3D wall-motion score index (WMSI) and2D speckle tracking-based GLS, GRS, GCS and2D-LVEF, WMSI were measured. The global correlations to infarct size by SPECT were measured and using ROC curve to evaluate myocardial strain detection myocardial infarction size value. Results:3D and2D myocardial strain had significant differences in various indices.3DGLS was significantly lower than2DGLS (P<0.05),3DGR and3DGCS were significantly higher than2DGRS and2DGCS (P<0.001), no significant differences between3D-LVEF and2D-LVEF,3D-WMS and2D-WMSI (P>0.05); with the increasing of MIA、3DGAS、3DGLS、2DGS、3DGCS、2DGCS、3DGRS、2DGRS、3D-LVEF、2D-LVEF were lower, but3D-WMSI and2D-WMSI were higher. The3D and2D strain indices have good correlations to infarct area by SPECT, the best correlations was2DGLS(r=0.794;P<0.01);3DGCS and3DGRS were more closely correlated to SPECT(r=0.677,0.574;P<0.01) than 2DGCS and2DGRS (r=0.656, r=0.546; P<0.01). ROC curve showed the3D and2D strain indices, LVEF and WMSI could distinguish between MIs of different infarct sizes (P<0.01),2DGLS had the highest diagnostic value, showed a sensitivity of80%and a specificity of95.1%for identification of LV infarct size>30%, but the ROC curve area (AUC) of3DGCS and3DGRS were higher than2DGCS and2DGRS. Conclusions:These findings indicate that3DSTE and2DSTE can distinguish between MIs of different infarct sizes, with the highest value of the diagnostic value of2DGLS,3DGRS and3DGCS compared with2DGRS and2DGCS in the diagnosis of increased value.