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The value of post systolic index (PSI) by speckle tracking echocardiography in locating target coronary artery disease has not been able to determine. Because of 30% of the normal myocardial segments with post systolic contractility, pathologic PSI only exists in patients with decreased systolic strain and thickening. We hypothesized that the myocardial PSI by speckle tracking echocardiography during rest status could be used in locating target coronary artery.
Study population consisted of 32 patients with first ST elevated myocardial infarction after primary percutaneous coronary intervention (PCI). Men 26, mean age 63±10 years. The time between onsets to treatment was 5.7± 2.0 hours. The lesion involved the left anterior descending artery (LAD) in 17 patients, left circumflex artery (LCX) in 5 patients and right coronary artery (RCA) 10 patients. Speckle tracking echocardiography was performed within 72 hours after PCI during rest status. Myocardial PSIs and strains of 17 myocardial segments were measured by an Echo-PAC computer workstation for automatic function imaging.
The territorial coronary arteries had been successfully recanalized in all patients. The mean global longitudinal strain was −12 ± 3.5 after PCI in 32 patients. PSI could be used to locate the lesion of LAD, LCX and RCA (Table).
PSI by speckle tracking echocardiography is a novel index to locate target coronary artery during rest status.
|Target vessels||Myocardial segments||AUC||P||Cutoff point||sensitivity||specificity|
|LAD||anterior wall at apical level||0.94||0.0001||>15.7||76||100|
|anterior septum at basal level||0.95||0.0001||>6||94||87|
|anterior septum at papillary muscle level||0.98||0.0001||>3||100||87|
|LCX||anterior lateral wall at basal level||0.79||0.0209||>15||80||96|
|anterior lateral wall at papillary muscle level||0.85||0.0021||>18||80||93|
|posterior lateral wall at papillary muscle level||0.82||0.0098||>31.3||60||96|
|RCA||inferior wall at basal level||0.87||0.0001||>1||100||73|
|posterior septum at basal level||0.78||0.004||>22.7||70||82|
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: Echo IX
Abstract Category: 18. Imaging: Echo
Presentation Number: 1227-347
- 2013 American College of Cardiology Foundation