Vol - 25, Issue - 7
About the Journal
[This article belongs to Volume - 25, Issue - 7]
International Medical Journal
Journal ID : IMJ-16-06-2020-508
Total View : 360

Abstract : Left ventricular dysfunction (LVD) is an important complication of coronary artery disease (CAD) and represents a powerful determinant of survival. the purpose of the current study was to assess scar tissue for patient with old myocardial infarction and LV systolic dysfunction by speckle tracking longitudinal strain using regional and global longitudinal strain and to compare it with late enhancement by CMR which is the gold standard method for assessment of scar transmurality, scar transmurality was the predictor of myocardial viability, the current study defined regional longitudinal strain cutoff value that discriminated between viable and non-viable myocardium. Methods: Thirty-eight patients with old myocardial infarction and LV systolic dysfunction from AL-Najaf cardiac center and AL-Nasirya cardiac center underwent transthoracic echocardiography to measure global and segmental (regional) longitudinal LV strain using two-dimensional speckle tracking and cine MRI followed by contrast-enhanced MRI to assess segmental LV function and the segmental/global (transmural) extent of scar tissue. The optimal cutoff value for regional strain to discriminate between segments with viable myocardium and segments with transmural scar was also determined. Results: A good correlation was found between global LV strain and the global extent of scar tissue on contrast-enhanced MRI (R= 0.518, n = 38, p = 0.001.). The mean segmental strain in segments with a scar score of 3 was -6.33% ± 2.28%, and for segments with a scar score of 4 was -2.67% ± 3.69%. A strain value of the cutoff value of segmental strain was calculated using (ROC curve) analysis, and it was found to be -7.5% discriminated between segments with viable myocardium and segments with transmural scar tissue on contrast-enhanced MRI with a sensitivity of 91.5% and specificity of 89.7% Conclusion: global and regional longitudinal strain measured with two-dimensional speckle tracking miscorrelated with the global and regional extent of scar transmurality assessed by contrast enhanced MRI. A cutoff value of -7.5% for regional strain discriminated between segments with viable myocardium and those with transmural scar tissue on contrast-enhanced MRI with a sensitivity of 91.5% and specificity of 89.7%

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