PMID- 19801018
OWN - NLM
STAT- MEDLINE
DCOM- 20091020
LR  - 20211020
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 104
IP  - 8
DP  - 2009 Oct 15
TI  - Usefulness of two-dimensional strain echocardiography to predict segmental 
      viability following acute myocardial infarction and optimization using bayesian 
      logistic spatial modeling.
PG  - 1023-9
LID - 10.1016/j.amjcard.2009.05.049 [doi]
AB  - Viability assessment after acute myocardial infarction (MI) is important to guide 
      revascularization. Two-dimensional strain echocardiography was shown to predict 
      viability, but the method assumed that strain in each segment is independent of 
      contiguous segments. The aim of this study was to test the hypotheses that 
      segmental strain after MI is spatially correlated and that using a Bayesian 
      approach improves the prediction of nonviable myocardium. Twenty-one subjects 
      (mean age 58 +/- 12 years, 6 women) with MI >or=2 weeks before recruitment 
      underwent 2-dimensional strain echocardiography and late gadolinium enhancement 
      (LGE) cardiac magnetic resonance imaging within 48 hours of each other. The heart 
      was divided into 16 segments, and longitudinal, radial, and circumferential 
      strains were measured using software. Using similar segmentation, LGE was 
      measured, and segments with >50% LGE were considered nonviable. Spearman's 
      analyses were used to assess the spatial correlation of strain, and 
      receiver-operating characteristic curve analysis was used to determine the 
      prediction of nonviable myocardium without and with a Bayesian logistic spatial 
      conditionally autoregressive (CAR) model. There was a significant spatial 
      correlation in strain and LGE among segments, especially in the apex. 
      Longitudinal strain was the best predictor of nonviability and was impaired in 
      nonviable myocardium (-12.1 +/- 0.6%, -8.0 +/- 0.6%, and -4.6 +/- 1% for 0%, 1% 
      to 50%, and >50% LGE, respectively, p <0.001). Use of the CAR model improved the 
      area under the curve for the detection of nonviable myocardium (from 0.7 to 
      0.94). A CAR probabilistic score of 0.17 had 88% sensitivity and 86% specificity 
      for detecting nonviable myocardium. In conclusion, longitudinal strain from 
      2-dimensional strain echocardiography can predict myocardial viability after MI, 
      and exploiting spatial correlations in segmental strain using Bayesian CAR 
      modeling enhances the ability of 2-dimensional strain to predict nonviable 
      myocardium.
FAU - Migrino, Raymond Q
AU  - Migrino RQ
AD  - Cardiovascular Division, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. 
      rmigrino@mcw.edu
FAU - Ahn, Kwang Woo
AU  - Ahn KW
FAU - Brahmbhatt, Tejas
AU  - Brahmbhatt T
FAU - Harmann, Leanne
AU  - Harmann L
FAU - Jurva, Jason
AU  - Jurva J
FAU - Pajewski, Nicholas M
AU  - Pajewski NM
LA  - eng
GR  - M01 RR000058/RR/NCRR NIH HHS/United States
GR  - M01 RR000058-455122/RR/NCRR NIH HHS/United States
GR  - T32 HL072757/HL/NHLBI NIH HHS/United States
GR  - M01-RR00058/RR/NCRR NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - *Bayes Theorem
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/*physiology
MH  - Myocardial Infarction/*diagnostic imaging/mortality/physiopathology
MH  - Predictive Value of Tests
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Ultrasonography
MH  - Ventricular Function, Left/*physiology
PMC - PMC2856659
MID - NIHMS151940
EDAT- 2009/10/06 06:00
MHDA- 2009/10/21 06:00
PMCR- 2010/10/15
CRDT- 2009/10/06 06:00
PHST- 2009/03/31 00:00 [received]
PHST- 2009/05/29 00:00 [revised]
PHST- 2009/05/29 00:00 [accepted]
PHST- 2009/10/06 06:00 [entrez]
PHST- 2009/10/06 06:00 [pubmed]
PHST- 2009/10/21 06:00 [medline]
PHST- 2010/10/15 00:00 [pmc-release]
AID - S0002-9149(09)01170-9 [pii]
AID - 10.1016/j.amjcard.2009.05.049 [doi]
PST - ppublish
SO  - Am J Cardiol. 2009 Oct 15;104(8):1023-9. doi: 10.1016/j.amjcard.2009.05.049.