Accuracy of three-dimensional systolic dyssynchrony and sphericity indexes for identifying early left ventricular remodeling after acute myocardial infarction

Arnas Karuzas, Egle Rumbinaite, Dovydas Verikas, Tomas Ptasinskas, Gintare Muckiene, Egle Kazakauskaite, Vytautas Zabiela, Renaldas Jurkevicius, Jolanta Justina Vaskelyte, Remigijus Zaliunas, Diana Zaliaduonyte-Peksiene, Arnas Karuzas, Egle Rumbinaite, Dovydas Verikas, Tomas Ptasinskas, Gintare Muckiene, Egle Kazakauskaite, Vytautas Zabiela, Renaldas Jurkevicius, Jolanta Justina Vaskelyte, Remigijus Zaliunas, Diana Zaliaduonyte-Peksiene

Abstract

Objective: Left ventricle (LV) geometry and dyssynchrony are associated with LV remodeling after acute myocardial infarction (AMI). The aim of this prospective study was to assess the diagnostic value of new three-dimensional echocardiography (3DE) parameters [sphericity (SI) and systolic dyssynchrony indexes (SDI)] for the prediction of LV remodeling after AMI and to compare them with two-dimensional echocardiography (2DE) parameters.

Methods: 2DE and 3DE were performed in 75 patients with AMI within 3 days from the onset of MI and 6 months later. LV remodeling was defined as a ≥15% increase in the LV end-diastolic volume (EDV) at follow-up. 3D SI was calculated by dividing EDV by the volume of a sphere whose diameter was derived from the major end-diastolic LV long axis. SDI was considered as a standard deviation of the time from cardiac cycle onset to minimum systolic volume in 16 LV segments.

Results: LV remodeling was identified in 34 (45%) patients using the 2DE method and in 22 (29%) patients using the 3DE method. Evaluated 3DE parameters, such as EDV [area under the receiver operating characteristic (ROC) curve (AUC) 0.742, sensitivity 71%, specificity 79%], end-systolic volume (AUC 0.729, sensitivity 69%, specificity 78%), SDI (AUC 0.777, sensitivity 73%, specificity 77%), and SI, had significant prognostic value for LV remodeling. According to the AUC, the highest predictive value had 3D SI (AUC 0.957, sensitivity 90%, specificity 91%).

Conclusion: 3DE parameters, especially 3D SI and SDI, play important roles in the prediction of LV remodeling after AMI and can be used in clinical practice.

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
ROC curves of 3D sphericity index and systolic dyssynchrony index. Cut-off values are shown

References

    1. Updated May 2017. Available from:URL:
    1. Abuomara HZA, Hassan OM, Rashid T, Baraka M. Myocardial performance index as an echocardiographic predictor of early in-hospital heart failure during first acute anterior ST-elevation myocardial infarction. Egypt Heart J. 2018;70:71–5.
    1. Kapetanakis S, Kearney MT, Siva A, Gall N, Cooklin M, Monaghan MJ. Real-time three-dimensional echocardiography:a novel technique to quantify global left ventricular mechanical dyssynchrony. Circulation. 2005;112:992–1000.
    1. Mannaerts HF, van der Heide JA, Kamp O, Stoel MG, Twisk J, Visser CA. Early identification of left ventricular remodelling after myocardial infarction, assessed by transthoracic 3D echocardiography. Eur Heart J. 2004;25:680–7.
    1. Wang TJ, Evans JC, Benjamin EJ, Levy D, LeRoy EC, Vasan RS. Natural history of asymptomatic left ventricular systolic dysfunction in the community. Circulation. 2003;108:977–82.
    1. Gopal AS, Shen Z, Sapin PM, Keller AM, Schnellbaecher MJ, Leibowitz DW, et al. Assessment of cardiac function by three-dimensional echocardiography compared with conventional noninvasive methods. Circulation. 1995;92:842–53.
    1. King DL, Harrison MR, King DL, Jr, Gopal AS, Martin RP, DeMaria AN. Improved reproducibility of left atrial and left ventricular measurements by guided three-dimensional echocardiography. J Am Coll Cardiol. 1992;20:1238–45.
    1. Sugeng L, Mor-Avi V, Lang RM. Three-dimensional echocardiography:coming of age. Heart. 2008;94:1123–5.
    1. Lang RM, Tsang W, Weinert L, Mor-Avi V, Chandra S. Valvular heart disease. The value of 3-dimensional echocardiography. J Am Coll Cardiol. 2011;58:1933–44.
    1. Simpson JM, Miller O. Three-dimensional echocardiography in congenital heart disease. Arch Cardiovasc Dis. 2011;104:45–56.
    1. Mollema SA, Su San Liem, Suffoletto MS, Bleeker GB, van der Hoeven BL, van de Veire NR, et al. Left ventricular dyssynchrony acutely after myocardial infarction predicts left ventricular remodeling. J Am Coll Cardiol. 2007;50:1532–40.
    1. Li XC, Jin FL, Jing C, Xiao Q, Liu Y, Ran ZS, et al. Predictive value of left ventricular remodeling by area strain based on three-dimensional wall-motion tracking after PCI in patients with recent NSTEMI. Ultrasound Med Biol. 2012;38:1491–501.
    1. Rizzello V, Poldermans D, Boersma E, Biagini E, Schinkel AF, Krenning B, et al. Opposite patterns of left ventricular remodeling after coronary revascularization in patients with ischemic cardiomyopathy:role of myocardial viability. Circulation. 2004;110:2383–8.
    1. Sarai M, Biswas S, Toyama H, Yamada A, Motoyama S, Iwase M, et al. Ventricular remodeling following acute myocardial infarction and its correlation with discordant perfusion and fatty acid metabolism. J Nucl Med. 2009;50(Suppl 2):1136.
    1. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults:an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39.
    1. Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T, et al. European Association of Echocardiography. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. Eur Heart J Cardiovasc Imaging. 2012;13:1–46.
    1. Visser CA. Left ventricular remodelling after myocardial infarction:importance of residual myocardial viability and ischaemia. Heart. 2003;89:1121–2.
    1. Opie LH, Commenford PJ, Gersh BJ, Pfeffer MA. Controversies in ventricular remodeling. Lancet. 2006;367:356–67.
    1. Gaudron P, Eilles C, Kugler I, Ertl G. Progressive left ventricular dysfunction and remodeling after myocardial infarction. Potential mechanisms and early predictors. Circulation. 1993;87:755–63.
    1. Zaliaduonyte-Peksiene D, Vaskelyte JJ, Mizariene V, Jurkevicius R, Zaliunas R. Does longitudinal strain predict left ventricular remodeling after myocardial infarction? Echocardiography. 2012;29:419–27.
    1. Bolognese L, Neskovic AN, Parodi G, Cerisano G, Buonamici P, Santoro GM, et al. Left ventricular remodeling after primary coronary angioplasty:Patterns of left ventricular dilation and long-term prognostic implications. Circulation. 2002;106:2351–7.
    1. Pirolo JS, Hutchins GM, Moore GW. Infarct expansion:pathologic analysis of 204 patients with a single myocardial infarct. J Am Coll Cardiol. 1986;7:349–54.
    1. Lund GK, Stork A, Muellerleile K, Barmeyer AA, Bansmann MP, Knefel M, et al. Prediction of left ventricular remodeling and analysis of infarct resorption in patients with reperfused myocardial infarcts by using contrast-enhanced MR imaging. Radiology. 2007;245:95–102.
    1. Konstam MA, Kramer DG, Patel AR, Maron MS, Udelson JE. Left ventricular remodeling in heart failure:current concepts in clinical significance and assessment. JACC Cardiovasc Imaging. 2011;4:98–108.
    1. Yang NI, Hung MJ, Cherng WJ, Wang CH, Cheng CW, Kuo LT. Analysis of left ventricular changes after acute myocardial infarction using transthoracic real-time three-dimensional echocardiography. Angiology. 2008-2009;59:688–94.
    1. Takeuchi M, Nishikage T, Mor-Avi V, Sugeng L, Weinert L, Nakai H, et al. Measurement of left ventricular mass by real time three-dimensional echocardiography:validation against magnetic resonance and comparison with two-dimensional and m-mode measurements. J Am Soc Echocardiogr. 2008;21:1001–5.
    1. Vieira ML, Oliveira WA, Cordovil A, Rodrigues AC, Mônaco CG, Afonso T, et al. 3D Echo pilot study of geometric left ventricular changes after acute myocardial infarction. Arq Bras Cardiol. 2013;101:43–51.
    1. Nucifora G, Bertini M, Marsan NA, Delgado V, Scholte AJ, Ng AC, et al. Impact of left ventricular dyssynchrony early on left ventricular function after first acute myocardial infarction. Am J Cardiol. 2010;105:306–11.
    1. Nucifora G, Bertini M, Ajmone Marsan N, Scholte AJ, Siebelink HM, Holman ER, et al. Temporal evolution of left ventricular dyssynchrony after myocardial infarction:relation with changes in left ventricular systolic function. Eur Heart J Cardiovasc Imaging. 2012;13:1041–6.
    1. Zhou Q, Deng Q, Huang J, Chen JL, Hu B, Guo RQ. Evaluation of left ventricular mechanical dyssynchrony in patients with heart failure after myocardial infarction by real-time three-dimensional echocardiography. Saudi Med J. 2012;33:256–61.
    1. Turan B, Yilmaz F, Karaahmet T, Tigen K, Mutlu B, Basaran Y. Role of left ventricular dyssynchrony in predicting remodeling after ST elevation myocardial infarction. Echocardiography. 2012;29:165–72.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe