Author + information
- Luigi P. Badano,
- Denisa Muraru,
- Giacomo Zoppellaro,
- Umberto Cucchini,
- Davide Ermacora,
- Manuel De Lazzari,
- Diletta Peluso,
- Martina Perazzolo-Marra and
- Sabino Iliceto
To evaluate if 2D/3D deformation parameters can improve the prediction of transmural myocardial necrosis over visual wall motion assessed on 3D LV data sets by experienced reader.
In 46 pts with recent STEMI (8±3 days after primary PCI), echo and delayed enhancement cardiac magnetic resonance (DE-CMR) studies were performed ≤24hrs apart. The relative amount of DE tissue per segment was used to define: no necrosis (0% DE), non-transmural (0-50% DE) and transmural necrosis (51-100% DE). All subjects were selected for good image quality, sinus rhythm and adequate 2D/3D speckle-tracking in at least 14 of 17 LV segments. LV function was assessed from three apical LV 2D views by measuring 2D longitudinal strain (2D-Lɛ), and from 4-beat LV full-volume data sets, assessing wall motion score (WMS) and measuring 3D longitudinal (Lɛ), circumferential (Cɛ), area (Aɛ) and radial (Rɛ) strains.
Among all parameters, 3D WMS (AUC= 0.87, 95%CI 0.83-0.90) and 2D-Lɛ (AUC= 0.83, 95%IC 0.80-0.87) were the best predictors of transmural extent of myocardial necrosis. The predictive value of 3D WMS was significantly higher than that of 3D Cɛ (AUC= 0.80, 95%IC 0.76-0.84; p<0.05), Aɛ (AUC= 0.81, 95%IC 0.77-0.84; p<0.05), Rɛ (AUC= 0.81, 95%IC 0.77-0.84), and Lɛ (AUC= 0.73, 95%IC 0.69-0.77). The incremental predictive value of 2D and 3D strain parameters over 3D WMSI was significant, but small. However, the AUC of the predictive model for transmural necrosis at DE-CMR which included 3D WMS, 2D Lɛ and 3D Cɛ was 0.91 (95%CI 0.88-0.93; p<0.0001).
Despite a good accuracy for both 3D Cɛ and 2D Lɛ, visual wall motion assessment by experienced reader on good-quality 3D data sets was found to be superior than strain quantification to predict transmural necrosis at DE-CMR.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: Echocardiographic Imaging of Patients with CAD: II
Abstract Category: 18. Imaging: Echo
Presentation Number: 1266-318
- 2013 American College of Cardiology Foundation