2014


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2014/№4

Use of EchoCG with speckle tracking for prediction of myocardium viability in patients with postinfarction cardiosclerosis

Gilyarov M. Yu., Murashova N. K., Novikova N. A., Sedov V. P., Syrkin A. L.
State Budgetary Educational Institution “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bld. 2, Moscow 119991

Keywords: diagnostics, myocardium viability, coronary heart disease, postinfarction cardiosclerosis, echocardiography

DOI: 10.18087/rhj.2014.4.1912

Background. Presence of viable myocardium has been reported to be associated with improved survival of IHD patients with LV dysfunction. Aim. To compare values of segmental longitudinal myocardial deformation at rest calculated with speckle-tracking EchoCG with results of coronary bypass surgery in patients with postinfarction cardiosclerosis by identification of viable myocardium. Materials and methods. 42 patients with postinfarction cardiosclerosis and impaired local contractility were evaluated. The patients were men aged 41 to 73 years (median age, 57 years) who were hospitalized for coronary bypass surgery. Standard EchoCG with evaluation of areas with impaired local contractility and speckle-tracking EchoCG for determination of myocardial longitudinal deformation values were performed in all patients before and 6 months after revascularization using an ultrasound scanner GE VIVID 7, Version 6.0.0. Postoperative myocardial longitudinal deformation values corresponding to improvement or recovery of myocardial kinetics were evaluated. Results. In total, 510 myocardial segments were analyzed. Originally, 333 segments were normokinetic; 102 segments were hypokinetic; and 72 segments were akinetic. According to speckle-tracking Eco-CG data, longitudinal deformation values were 15.7±5.5 for normokinesis; 9.3±4.6 for hypokinesis; and 5.3±4.5 for akinesis (p<0.0001). Relationships between longitudinal deformation values at rest and improvements of myocardial contractility after coronary bypass surgery were analyzed using the ROC curve. The threshold value of longitudinal myocardial deformation corresponding to contractility recovery after revascularization was determined using the Youden index (sensitivity + specificity – 1) as –10.5. Therefore, improved local myocardial contractility was observed at deformation values of –10.5 or lower with specificity of 53 % and sensitivity of 83 %. Conclusion. Values of segmental longitudinal myocardial deformation at rest lower than –10.5 predict myocardium viability in the area of locally impaired contractility after revascularization with sensitivity of 83 % and specificity of 53 %.
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Gilyarov M. Yu., Murashova N. K., Novikova N. A. et al. Use of EchoCG with speckle tracking for prediction of myocardium viability in patients with postinfarction cardiosclerosis. Russian Heart Journal. 2014;78 (4):195–198

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