Abstract：Objective To explore a new method to evaluate myocardium viability by two-dimensional speckle tracking imaging (2DSTI) combined with adenosine stress echocardiography in the patients with myocardial infarction. Methods The regional peak rotation (PRot) and peak-systole rotation rate (PRRs) of each segment were detected using 2DSTI in 35 cases of patients with elderly myocardial infarction at rest and adenosine (140 μg?kg-1?min-1, continuing 6 min). And then, every corresponding segment were defined as viable or non-viable myocardium according to radionuclide myocardial perfusion / metabolic imaging. Results At baseline, there was no significant difference in PRot and PRRs between viable and nonviable myocardium segments. And under adenosine stress, PRot and PRRs of myocardial segments at the mitral or apical levels in viable group increased significantly while didn’t change remarkably in the nonviable in contrast with those at rest. Compared with those in nonviable group, PRot and PRRs of myocardial segments at mitral or apical levels in viable group increased significantly respectively. Using a cutoff of 14.5%, △PRot had a sensitivity of 91.26% and specificity of 88.23% for distinguishing viable from nonviable segment. Using a cutoff of 18.5%, △PRRs had a sensitivity of 88.89% and specificity of 86.27% for distinguishing viable from nonviable segment. Combined with PRot and PRRs, the sensitivity and specificity could reach 94.41% and 90.19%. Conclusion Speckle tracking imaging combined with adenosine stress echocardiography could provide a reliable and new method for identifying viable myocardium from evaluating myocardium rotation motion.
夏梦宁，张平洋，方玲玲，马小五，冉红，吴文芳，张佳佳. 斑点追踪成像结合腺苷负荷超声评价心肌梗死患者心肌存活性[J]. 中国医疗设备, 2013, 28(11): 23-26.
XIA Meng-ning, ZHANG Ping-yang, FANG Ling-ling, MA Xiao-wu, RAN Hong, WU Wen-fang, ZHANG Jia-jia. Evaluation of Viable Myocardium by Speckle Tracking Imaging under Adenosine Stress Echocardiography in Patients with Myocardial Infarction. China Medical Devices, 2013, 28(11): 23-26.
Stoylen A,Heimdal A,Bjornstad K,et al.Strain rate imaging by ultrasound in the diagnosis of regional dysfunction of the left ventricle [J].Echocardiography,1999,16(4):321-329.
[6]
Leitman M,Lysyansky P,Sidenko S,et a1.Two-dimensional strain: a novel software for reahime quantitative echocardiographic assessment of myocardial function[J].J Am Soc Echocardiogr,2004,17(10):1021-1029.
[7]
Stoylen A,Heimdal A,Bjornstad K,et al.Strain rate imaging by ultrasound in the diagnosis of regional dysfunction of the left ventricle [J].Echocardiography,1999,16(4):321-329.
[8]
Reisner S,Lysyansky P,Agmon Y,et a1.Global longitudinal strain: a novel index of left ventricular systolic function[J].J Am Soc Echocardiogr,2004,17(6):630-633.
[9]
Sutherland G R,Di Salvo G,Claus P,et al.Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function[J].J Am Soc Echocardiogr,2004,17(7):788-802.
[1]
Butz T,Lang CN,van Bracht M,et al.Segment-orientated analysis of two-dimensional strain and strain rate as assessed by velocity vector imaging in patients with acute myocardial infarction[J].Int J Med Sci,2011,8(2):106-113.
[2]
Ammirati E,Guida V,Rimoldi OE,et al.Revascularization of the hibernated myocardium:a clinical problem still unsolved[J].G Ital Cardiol (Rome),2012,13(2):102-109.
Leitman M,Lysyansky P,Sidenko S,et a1.Two-dimensional strain: a novel software for reahime quantitative echocardiographic assessment of myocardial function[J].J Am Soc Echocardiogr,2004,17(10):1021-1029.
[9]
Sutherland G R,Di Salvo G,Claus P,et al.Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function[J].J Am Soc Echocardiogr,2004,17(7):788-802.
[8]
Reisner S,Lysyansky P,Agmon Y,et a1.Global longitudinal strain: a novel index of left ventricular systolic function[J].J Am Soc Echocardiogr,2004,17(6):630-633.
