Two‐Dimensional Speckle Tracking Echocardiography for the Prediction of Reversible Myocardial Dysfunction after Acute Myocardial Infarction: Comparison with Magnetic Resonance Imaging

Background We aimed to determine the predictive value of longitudinal, circumferential, and radial strains by two‐dimensional speckle tracking echocardiography ( 2DSTE ) for improvement in cardiac function after acute myocardial infarction ( AMI ) compared with that of contrast‐enhanced cardiac magnetic resonance imaging (ce MRI ). Methods In 35 patients with first‐time AMI , myocardial viability was assessed to predict recovery of function at follow‐up (7 ± 2 months), prospectively. For each left ventricular segment, each peak strains were determined using 2DSTE , and the relative extent of hyperenhancement was assessed using ce MRI . Results Of 176 segments with impaired function early after AMI , 99 segments showed regional recovery. Compared with segments showing functional improvement, those that failed to recover had lower peak radial (20 ± 16% vs. 32 ± 21%; P < 0.001), circumferential (−10 ± 5% vs. −20 ± 6%; P < 0.001), and longitudinal (−10 ± 5% vs. −14 ± 5%; P < 0.001) strain and a greater extent of hyperenhancement (71 ± 22% vs. 27 ± 20%; P < 0.001). Among strain parameters, circumferential strain yielded greater area under the curve ( AUC ; 0.899) than radial and longitudinal strain (0.682 and 0.718, respectively). The predictive value of circumferential strain (sensitivity 81.0%, specificity 79.6%, at a cutoff value of −14.3%) could be comparable to that of hyperenhancement (sensitivity 86.2%, specificity 83.9%, AUC 0.921, at a cutoff value of 47%) (P = 0.439). Conclusion Circumferential strain can identify reversible myocardial dysfunction after AMI with a diagnostic ability comparable to that of ce MRI .