Assessment of the regional myocardial deformation changes and viability in anterior acute myocardial infarction patients by strain and strain rate imaging

Objective: To prospectively evaluate the regional myocardial deformation changes and viability in anterior acute myocardial infarction (AMI) patients before and after primary coronary intervention (PCI) by strain (S)/strain rate (Sr) imaging. Methods: Twenty-one patients presented during the first six hours of an anterior AMI and twenty controls were included in this study. Echocardiographic recordings were obtained from the apical/parasternal images just before PCI, one week and one month after PCI. The S/Sr and velocity (V) were measured from the basal mid and apical segments of the walls supplied by the left anterior descending artery. Myocardial perfusion scintigraphy was performed in the 1st month after PCI. Mann-Whitney U and Wilcoxon tests were used for statistical analysis. Results: Acute myocardial infarction resulted in the reduction of deformation indices (S/Sr/V) in all segments. Deformation indices were increased after successful PCI. The S/Sr values of the normal and ischemic segments after PCI were higher compared to the baseline (ischemic Sr:-1.3±0.3 vs. -1.1±0.3, p=0.04). No difference was noted in the S/Sr values of the necrotic segments during the first week (Sr:-1.1±0.3 vs. -1.0±0.3, p=0.054). For V measurements, no difference was observed between the viability types at the follow-up measurements (p 0.05). Conclusion: The remedial effect of PCI on the deformation values was observed in the first week and continued during the first month. In the early reperfusion period, S/Sr indices have the potential to differentiate necrotic tissue from other viability types. Strain/Strain rate imaging can be used for determination of myocardial deformation changes and parameters of viability. However, V values were insufficient.