Research Article
Volume 7 Issue 12 - 2020
Early Prediction of Myocardial Viability Following Acute Myocardial Infarction by Two-Dimensional Speckle Imaging
Mohamed Abdelmonem Aboutaha*, Neama Ali Elmeligy, Azza Ali Katta, Osama Sanad Arafa, Mohamed El Bordy, Mohamed Samir Hamada, Hany Abd El Salam Basiouny and Mohamed Mahrous Ali
Department of Cardiology, Benha University, National Heart Institute, Egypt
*Corresponding Author: Mohamed Abdelmonem Aboutaha, Department of Cardiology, Benha University, National Heart Institute, Egypt.
Received: August 11, 2020; Published: November 28, 2020


Background: Identifying the transmural extent of myocardial necrosis and the degree of myocardial viability in acute myocardial infarction (AMI) is important clinically.

Aim of the Study: The aim of this study was to assess myocardial viability using two-dimensional speckle tracking imaging (2D-STI) in patients with AMI.

Methods: 2D-STI was performed within three days of hospital admission and six months after primary percutaneous coronary intervention (PCI) in 50 patients with AMI, who had a left anterior descending coronary artery (LAD) culprit lesion. In addition, 25 patients who had minimal stenotic lesions (< 30% stenosis) on coronary angiography were also included in the control group. At six months dobutamine echocardiography was performed for viability assessment in seven segments of the LAD territory. According to the recovery of wall motion abnormality, segments were classified as viable or non-viable.

Results: A total of 288 segments were viable, and 62 were nonviable. There is statistical significant difference between the viable and nonviable segments in the peak systolic strain and the peak systolic strain rate measured within three days from acute myocardial infarction. AUC for peak systolic strain (0.957, p. < 0.001), 95%C.I. (0.937 - 0.976) showed that a cut off level of < -9 had sensitivity of 86.11 and specificity 87.1 for prediction of viable myocardium. AUC for peak systolic strain rate (0.87, p. < 0.001), 95%C.I. (0.809 - 0.931) showed that a cut off level of < -0.7 had sensitivity of 91.6 and specificity 74.19 for prediction of viable myocardium.

Conclusion: In patients with recent first acute MI, Strain and strain rate measurements are feasible, inexpensive, quantitative, and rapid methods that can predict myocardial viability with high sensitivity and specificity.

Keywords: Acute Myocardial Infarction (AMI); Two-Dimensional Speckle Tracking Imaging (2D-STI); Percutaneous Coronary Intervention (PCI)


  1. O’Gara PT., et al. “2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines”. Circulation4 (2013): e362-e425.
  2. Vartdal T., et al. “Early prediction of infarct size by strain doppler echocardiography after coronary reperfusion”. Journal of the American College of Cardiology 49 (2007): 1715-1721.
  3. Al Moudiet M and Sun ZH. “Diagnostic value of (18)F-FDG PET in the assessment of myocardial viability in coronary artery disease: A comparative study with (99m)Tc SPECT and echocardiography”. Journal of Geriatric Cardiology 11 (2014): 229-236.
  4. Habis M., et al. “Acute myocardial infarction early viability assessment by 64-slice computed tomography immediately after coronary angiography: comparison with low-dose dobutamine echocardiography”. JACC: Journal of the American College of Cardiology 49 (2007): 1178-1185.
  5. Amundsen B., et al. “Non-invasive myocardial strain measurement by speckle tracking echocardiography”. JACC: Journal of the American College of Cardiology 47 (2006): 789-793.
  6. Altiok E., et al. “Myocardial deformation imaging by two-dimensional speckle-tracking echocardiography for prediction of global and segmental functional changes after acute myocardial infarction: a comparison with late gadolinium enhancement cardiac magnetic resonance”. Journal American Society of Echocardiography 27 (2014): 249-257.
  7. Hanekom L., et al. “Incremental value of strain rate analysis as an adjunct to wall-motion scoring for assessment of myocardial viability by dobutamine echocardiography: A follow-up study after revascularization”. Circulation 11 (2005): 3892-3900.
  8. Lyseggen E., et al. “Myocardial strain analysis in acute coronary occlusion: A tool to assess myocardial viability and reperfusion”. Circulation 112 (2005): 3901-3910.
  9. Vartdal T., et al. “Early prediction of infarct size by strain doppler echocardiography after coronary reperfusion”. Journal of the American College of Cardiology 49 (2007): 1715-1721.
  10. Shokr Aly M., et al. “Myocardial Viability Assessment by Dobutamine Echocardiography using Tissue Doppler and Speckle-Tracking: Comparison with SPECT”. ARC Journal of Cardiology 2 (2016): 1-12.
  11. Martin H., et al. “Speckle tracking echocardiography derived systolic longitudinal strain is better than rest single photon emission tomography perfusion imaging for nonviable myocardium identification”. Biomedical papers of the Medical Faculty of the University 157 (2013): 12-21.
  12. Loïc B., et al. “Longitudinal Strain Is a Marker of Microvascular Obstruction and Infarct Size in Patients with Acute ST-Segment Elevation Myocardial Infarction”. Journal European PMC 10 (2014): 1371.
  13. Cimino S., et al. “Global and regional longitudinal strain assessed by two-dimensional speckle tracking echocardiography identifies early myocardial dysfunction and transmural extent of myocardial scar in patients with acute ST elevation myocardial infarction and relatively preserved LV function”. European Heart Journal- Cardiovascular Imaging 14 (2013): 805-811.
  14. Chan J., et al. “Differentiation of subendocardial and transmural myocardial infarction using two-dimensional strain rate imaging to assess short and long axis function”. Journal of the American College of Cardiology 10 (2006): 2026-2033.
  15. Jong Shin Woo., et al. “Early prediction of myocardial viability after acute myocardial infarction by two-dimensional speckle tracking imaging”. Journal of Geriatric Cardiology 12 (2015): 474-481.
Citation: Mohamed Abdelmonem Aboutaha., et al. “Early Prediction of Myocardial Viability Following Acute Myocardial Infarction by Two- Dimensional Speckle Imaging”. EC Cardiology 7.12 (2020): 34-45.

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