PMID- 27108156 OWN - NLM STAT- MEDLINE DCOM- 20170221 LR - 20181113 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 105 IP - 10 DP - 2016 Oct TI - Temporal deformation pattern in acute and late phases of ST-elevation myocardial infarction: incremental value of longitudinal post-systolic strain to assess myocardial viability. PG - 815-26 LID - 10.1007/s00392-016-0989-6 [doi] AB - BACKGROUND: Identification of transmural extent and degree of non-viability after ST-segment elevation myocardial infarction (STEMI) is clinically important. The objective of the present study was to assess the regional mechanics and temporal deformation patterns using speckle tracking echocardiography (STE) in acute and later phases of STEMI to predict myocardial damage in these patients. METHODS AND RESULTS: Ninety-eight patients with first STEMI underwent both echocardiography and cardiac magnetic resonance imaging in acute phase and at 6 months follow-up with 2D STE-derived measurements of peak longitudinal strain (PLS), Pre-STretch index (PST) and post-systolic deformation index (PSI). For each segment, late gadolinium enhancement (LGE) was defined as transmural (LGE >66 %) or non-transmural (<66 %). Global deformation values were significantly correlated with LVEFCMR and infarct size at both visits. A significantly lower value of segmental PLS and higher PSI and PST in necrotic segments were observed comparatively to control, adjacent and remote segments. The best parameters to predict transmural extent in acute phase were PSI with a cutoff value of 8 % (AUC: 0.84) and PLS with a cutoff value of -13 % (AUC: 0.86). PST showed high specificity, but poor sensitivity in predicting transmural extent. More importantly, the addition of PSI and PST to PLS in acute phase was associated with improved prediction of viability at 6 months (integrated discrimination improvement 2.5 % p < 0.01; net reclassification improvement 27 %; p < 0.01). CONCLUSIONS: All systolic deformation values separated transmural from non-transmural scarring. PLS combined with additional information relative to post-systolic deformation appears to be the most informative parameters to predict the transmural extent of MI in the early and late phases of MI. CLINICAL TRIAL REGISTRATION: http://clinicaltrials.gov/show/NCT01109225 ; NCT01109225. FAU - Huttin, Olivier AU - Huttin O AD - Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, 54511, Vandoeuvre les Nancy, France. o.huttin@chu-nancy.fr. FAU - Marie, Pierre-Yves AU - Marie PY AD - Service de Medecine Nucleaire, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Benichou, Maxime AU - Benichou M AD - Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, 54511, Vandoeuvre les Nancy, France. FAU - Bozec, Erwan AU - Bozec E AD - INSERM Centre d'Investigation Clinique CIC-P 9501, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Lemoine, Simon AU - Lemoine S AD - Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, 54511, Vandoeuvre les Nancy, France. FAU - Mandry, Damien AU - Mandry D AD - Centre d'Investigations Cliniques IADI U947, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Juilliere, Yves AU - Juilliere Y AD - Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, 54511, Vandoeuvre les Nancy, France. FAU - Sadoul, Nicolas AU - Sadoul N AD - Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, 54511, Vandoeuvre les Nancy, France. FAU - Micard, Emilien AU - Micard E AD - Centre d'Investigations Cliniques IADI U947, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Duarte, Kevin AU - Duarte K AD - INSERM Centre d'Investigation Clinique CIC-P 9501, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Beaumont, Marine AU - Beaumont M AD - Centre d'Investigations Cliniques IADI U947, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Rossignol, Patrick AU - Rossignol P AD - INSERM Centre d'Investigation Clinique CIC-P 9501, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Girerd, Nicolas AU - Girerd N AD - INSERM Centre d'Investigation Clinique CIC-P 9501, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France. FAU - Selton-Suty, Christine AU - Selton-Suty C AD - Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, 54511, Vandoeuvre les Nancy, France. LA - eng SI - ClinicalTrials.gov/NCT01109225 PT - Journal Article DEP - 20160423 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - 0 (Contrast Media) SB - IM MH - Aged MH - Biomechanical Phenomena MH - Contrast Media MH - *Echocardiography MH - Female MH - France MH - Humans MH - *Magnetic Resonance Imaging, Cine MH - Male MH - Middle Aged MH - *Myocardial Contraction MH - Myocardium/*pathology MH - Observer Variation MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Reproducibility of Results MH - ST Elevation Myocardial Infarction/*diagnostic imaging/pathology/physiopathology/therapy MH - Stress, Mechanical MH - Time Factors MH - Tissue Survival MH - *Ventricular Function, Left OTO - NOTNLM OT - Deformation mechanics OT - Echocardiography OT - Left ventricular function OT - Myocardial infarction OT - Strain EDAT- 2016/04/25 06:00 MHDA- 2017/02/22 06:00 CRDT- 2016/04/25 06:00 PHST- 2016/02/06 00:00 [received] PHST- 2016/04/12 00:00 [accepted] PHST- 2016/04/25 06:00 [entrez] PHST- 2016/04/25 06:00 [pubmed] PHST- 2017/02/22 06:00 [medline] AID - 10.1007/s00392-016-0989-6 [pii] AID - 10.1007/s00392-016-0989-6 [doi] PST - ppublish SO - Clin Res Cardiol. 2016 Oct;105(10):815-26. doi: 10.1007/s00392-016-0989-6. Epub 2016 Apr 23.