Assessment of Myocardial Infarct Size by Three-Dimensional and Two-Dimensional Speckle Tracking Echocardiography: A Comparative Study to Single Photon Emission Computed Tomography

Echocardiography. 2015 Oct;32(10):1539-46. doi: 10.1111/echo.12901. Epub 2015 Feb 15.

Abstract

Objective: To compare three-dimensional (3D) and two-dimensional (2D) speckle tracking echocardiography (STE) techniques in the assessment of left ventricular function and myocardial infarct size (MIS).

Methods: Thirty-two patients diagnosed with ST elevation myocardial infarction and 18 healthy control patients underwent 2D echocardiography, 3D echocardiography, and single photon emission computed tomography (SPECT). 3D left ventricular global area strain (GAS), 2D and 3D global longitudinal strain (GLS), global radial strain (GRS) as well as global circumferential strain (GCS) were analyzed to correlate with myocardial infarct size detected by SPECT. 2D and 3D left ventricular ejection fraction (LVEF) as well as 2D and 3D wall motion score index (WMSI) also were measured using conventional echocardiography.

Results: The 2D-GLS values were significantly higher than that of 3D-GLS, while 2D-GCS and GRS were significantly lower than 3D-GCS and GRS, respectively. However, no significant differences in LVEF and WMSI could be observed between 2D and 3D echocardiography. Myocardial strain indices, LVEF, and WMSI using 2D and 3D echocardiography also had good correlations with MIS as measured by SPECT. ROC curve analysis showed that the 3D and 2D myocardial indices, LVEF, and WMSI could distinguish between small and large MIS, while 2D-GLS had the highest AUC.

Conclusion: The 2D and 3D myocardial strain indices correlated well with MIS by SPECT. Among them, the 2D-GLS showed the highest diagnostic value, while 3D-GRS and GCS had better diagnostic value than 2D-GRS and GCS.

Keywords: myocardial infarction; myocardial strain; single photon emission computed tomography; speckle tracking echocardiography; three-dimensional; two-dimensional.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Echocardiography / methods*
  • Echocardiography, Three-Dimensional
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging*
  • Myocardial Infarction / pathology
  • Myocardial Infarction / therapy
  • Percutaneous Coronary Intervention
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi