engleski

Global and regional assessment of left ventricle longitudinal strain in patients with non-ST- segment elevation myocardial infarction: going further in left ventricular function in acute settings

Strain echocardiography is a validated and accurate measure of regional systolic left ventricular function, superior to visual assessment of wall motion in detection and quantification of regional systolic function and is sensitive tool for detection of ischaemia. The ischaemic risk area can only be assessed clinically by perfusion imaging with single photon emission computed tomography or contrast echocardiography, and these modalities are not available in the emergency setting at most hospitals. We demonstrate the use of a non- invasive bedside imaging modality, global and regional assessment of left ventricle (LV) longitudinal strain, to identify acute coronary lesion in the Non-ST-segment elevation (NSTE) acute coronary syndrome (ACS). We present a 45- years-old female with acute myocardial infarction NSTE. Biplane LV ejection fraction calculation using the Simpson's method was performed showing preserved LVEF (52-57%). However, this method is dependent on visual delineation of the endocardial border, which can be a challenge in patients with poor acoustic conditions. This limitation could contribute to the superiority of global longitudial strain (GLS) over LVEF, but the same challenges are present when performing 2D speckle tracking. A bull's eye plot strain values demonstrated a functional risk area of eight adjacent segments with strain greater than or equal -12%. We present 2D strain echocardiography as a diagnostic tool to identify patients with NSTE-ACS, who may benefit from urgent reperfusion therapy.Strain echocardiography is valuable tool for better risk stratification and therapy in patients with NSTE-ACS in acute seetings.

left ventricle longitudinal strain ; acute coronary syndrome

Rad je prikazan na 8th Croatian Echocardiography Meeting with International Participation; Opatija, May 28-30, 2015