Ultrasonic Strain Versus Coronary Flow Velocity Pattern for Predicting Regional Wall Motion Recovery After Primary Coronary Intervention for Acute Myocardial Infarction

Background: Strain Doppler echocardiography can detect regional myocardial dysfunction after acute myocardial infarction ( AMI). The aim of this study was to assess the utility of strain in predicting regional wall motion recovery after AMI compared with the coronary flow velocity pattern. Methods: Thirty-three patients with anterior AMIs undergoing successful coronary intervention were included. Longitudinal myocardial strain and coronary flow velocity were measured < 24 hours after coronary intervention. Regional wall motion was analyzed by the anterior wall motion score index (A-WMSI). Results: End-systolic strain (r = 0.72, P < .0001), peak strain (r = 0.58, P < .005), and corrected time to peak strain ( the time delay from end-systolic to peak strain divided by the RR interval) (r = 0.80, P < .0001) showed good correlations with A-WMSI at 4 weeks. Similarly, diastolic deceleration time was significantly correlated with A-WMSI at 4 weeks (r = 0.69, P < .0001). The diagnostic value in predicting wall motion recovery was compared using a receiver operating characteristic curve. The area under the curve of corrected time to peak strain tended to be larger than that of diastolic deceleration time (0.94 +/- 0.04 vs 0.86 +/- 0.06). Conclusion: Strain can predict left ventricular wall motion recovery in patients with AMIs after coronary intervention comparable with predictions using the coronary flow velocity pattern. (J Am Soc Echocardiogr 2008; 21: 1369-1375.)