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CC BY-NC-ND 4.0 · Avicenna J Med 2019; 9(02): 48-54
DOI: 10.4103/AJM.AJM_168_18
ORIGINAL ARTICLE

Left ventricular dyssynchrony assessment using tissue synchronization imaging in acute myocardial infarction

Ahmed S Azazy
Department of Cardiology, King Saud Medical City, Riyadh, Saudi Arabia
,
Mahmoud Soliman
Department of Cardiology, Meoufiya University Hospital, Meoufiya, Egypt
,
Rehab Yaseen
Department of Cardiology, Meoufiya University Hospital, Meoufiya, Egypt
,
Morad Mena
Department of Cardiology, Meoufiya University Hospital, Meoufiya, Egypt
,
Haitham Sakr
Department of Cardiology, King Saud Medical City, Riyadh, Saudi Arabia
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Objectives: To assess left ventricular (LV) dyssynchrony in patients with ST elevation myocardial infarction (STEMI). Background: Mechanical synchronization disorder leads to a decrease in LV ejection fraction (LVEF) and stroke volume, an abnormal distribution of wall tension, and increase in workload during cardiac contraction. Methods: We enrolled 56 participants, 36 with acute STEMI and 20 healthy controls. The automatically color-coded time to peak myocardial velocity was measured using a 6mm sample volume, manually positioned within the two-dimensional-tissue strain image of the 12 basal and middle LV segments. Results: A significant delay was found between the septal-lateral and septal-posterior walls in patients with STEMI compared to patients in the control group (36.36 vs. −6.0ms, P = 0.036; and 42.7 vs. 23.94ms, P = 0.042, respectively). Furthermore, all segment maximum differences and all segment standard deviation (SD; dyssynchrony index) were found to be significantly higher in the STEMI group (131.28 vs. 95.45ms, P = 0.013; and 44.47 vs. 26.45ms, P = 0.001, respectively). A significant delay between the septal-lateral walls and septal-posterior walls, all segment maximum difference, and all segment SD (dyssynchrony index) were found in patients with complicated STEMI (70.89 vs. 15.83ms, P = 0.038; 57.44 vs. 19.06ms, P = 0.040; 138.11 vs. 100.0ms, P = 0.035; and 45.44 vs. 32.50ms, P = 0.021, respectively). There was a significant negative correlation between tissue synchronization imaging parameters and LVEF, and a positive correlation with LV end systolic dimension. Conclusion: Patients with acute STEMI showed significant LV dyssynchrony, which was an independent predictor of inhospital complications.

Keywords

Left ventricular dyssynchrony - myocardial infarction - tissue synchronization imaging


Publication History

Article published online:
09 August 2021

© 2019. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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