Automated Tissue Doppler Imaging for Identification of Occluded Coronary Artery in Patients with Suspected Non-ST-elevation Myocardial Infarction

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2023 Jan 30

PMID 36715881

Authors

Marlene Iversen Halvorsrod

Gabriel Kiss

Thomas Dahlslett

Asbjorn Stoylen

Bjornar Grenne

Affiliations

Soon will be listed here.

Abstract

Purpose: Identification of regional dysfunction is important for early risk stratification in patients with suspected non-ST-elevation myocardial infarction (NSTEMI). Strain echocardiography enables quantification of segmental myocardial deformation. However, the clinical use is hampered by time-consuming manual measurements. We aimed to evaluate whether an in-house developed software for automated analysis of segmental myocardial deformation based on tissue Doppler imaging (TDI) could predict coronary occlusion in patients with suspected NSTEMI.

Methods: Eighty-four patients with suspected NSTEMI were included in the analysis. Echocardiography was performed at admission. Strain, strain rate and post-systolic shortening index (PSI) were analyzed by the automated TDI-based tool and the ability to predict coronary occlusion was assessed. For comparison, strain measurements were performed both by manual TDI-based analyses and by semi-automatic speckle tracking echocardiography (STE). All patients underwent coronary angiography.

Results: Seventeen patients had an acute coronary occlusion. Global strain and PSI by STE were able to differentiate occluded from non-occluded culprit lesions (respectively - 15.0% vs. -17.1%, and 8.1% vs. 5.1%, both p-values < 0.05) and identify patients with an acute coronary occlusion (AUC 0.66 for both strain and PSI). Measurements of strain, strain rate and PSI based on TDI were not significantly different between occluded and non-occluded territories.

Conclusion: Automated measurements of myocardial deformation based on TDI were not able to identify acute coronary occlusion in patients with suspected NSTEMI. However, this study confirms the potential of strain by STE for early risk stratification in patients with chest pain.

Citing Articles

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Ji M, Zhang L, Gao L, Lin Y, He Q, Xie M Diagnostics (Basel). 2024; 14(1).

PMID: 38201397 PMC: 10795743. DOI: 10.3390/diagnostics14010088.

References

Asanuma T, Nakatani S . Myocardial ischaemia and post-systolic shortening. Heart. 2015; 101(7):509-16. DOI: 10.1136/heartjnl-2013-305403. View

Grenne B, Eek C, Sjoli B, Dahlslett T, Uchto M, Hol P . Acute coronary occlusion in non-ST-elevation acute coronary syndrome: outcome and early identification by strain echocardiography. Heart. 2010; 96(19):1550-6. DOI: 10.1136/hrt.2009.188391. View

Grenne B, Eek C, Sjoli B, Skulstad H, Aakhus S, Smiseth O . Changes of myocardial function in patients with non-ST-elevation acute coronary syndrome awaiting coronary angiography. Am J Cardiol. 2010; 105(9):1212-8. DOI: 10.1016/j.amjcard.2009.12.036. View

Keddeas V, Swelim S, Selim G . Role of 2D speckle tracking echocardiography in predicting acute coronary occlusion in patients with non ST-segment elevation myocardial infarction. Egypt Heart J. 2018; 69(2):103-110. PMC: 5839360. DOI: 10.1016/j.ehj.2016.10.005. View

Tibaldi M, Ruiz C, Servato M, Urinovsky M, Moreyra E, Sarmiento P . Left Ventricular Longitudinal Global Strain to Predict Severe Coronary Disease in Patients with Precordial Pain Suggestive of Non-ST-Segment Elevation Acute Coronary Syndrome. J Cardiovasc Echogr. 2021; 30(4):187-192. PMC: 8021081. DOI: 10.4103/jcecho.jcecho_57_20. View

Eek C, Grenne B, Brunvand H, Aakhus S, Endresen K, Smiseth O . Strain echocardiography predicts acute coronary occlusion in patients with non-ST-segment elevation acute coronary syndrome. Eur J Echocardiogr. 2010; 11(6):501-8. DOI: 10.1093/ejechocard/jeq008. View

Brekke B, Nilsen L, Lund J, Torp H, Bjastad T, Amundsen B . Ultra-high frame rate tissue Doppler imaging. Ultrasound Med Biol. 2013; 40(1):222-31. DOI: 10.1016/j.ultrasmedbio.2013.09.012. View

Thorstensen A, Amundsen B, Dalen H, Hala P, Kiss G, Aase S . Strain rate imaging combined with wall motion analysis gives incremental value in direct quantification of myocardial infarct size. Eur Heart J Cardiovasc Imaging. 2012; 13(11):914-21. DOI: 10.1093/ehjci/jes070. View

Bassand J, Hamm C, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F . Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2007; 28(13):1598-660. DOI: 10.1093/eurheartj/ehm161. View

10.

Lang R, Badano L, Mor-Avi V, Afilalo J, Armstrong A, Ernande L . Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015; 16(3):233-70. DOI: 10.1093/ehjci/jev014. View

11.

Voigt J, Lindenmeier G, Exner B, Regenfus M, Werner D, Reulbach U . Incidence and characteristics of segmental postsystolic longitudinal shortening in normal, acutely ischemic, and scarred myocardium. J Am Soc Echocardiogr. 2003; 16(5):415-23. DOI: 10.1016/s0894-7317(03)00111-1. View

12.

Cerqueira M, Weissman N, Dilsizian V, Jacobs A, Kaul S, Laskey W . Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002; 105(4):539-42. DOI: 10.1161/hc0402.102975. View

13.

Voigt J, Pedrizzetti G, Lysyansky P, Marwick T, Houle H, Baumann R . Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2014; 16(1):1-11. DOI: 10.1093/ehjci/jeu184. View

14.

Zahid W, Johnson J, Westholm C, Eek C, Haugaa K, Smedsrud M . Mitral annular displacement by Doppler tissue imaging may identify coronary occlusion and predict mortality in patients with non-ST-elevation myocardial infarction. J Am Soc Echocardiogr. 2013; 26(8):875-84. DOI: 10.1016/j.echo.2013.05.011. View

15.

Dalen H, Thorstensen A, Aase S, Ingul C, Torp H, Vatten L . Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway. Eur J Echocardiogr. 2009; 11(2):176-83. DOI: 10.1093/ejechocard/jep194. View

16.

Hanekom L, Cho G, Leano R, Jeffriess L, Marwick T . Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography: an angiographic correlation. Eur Heart J. 2007; 28(14):1765-72. DOI: 10.1093/eurheartj/ehm188. View

17.

Mirea O, Pagourelias E, Duchenne J, Bogaert J, Thomas J, Badano L . Variability and Reproducibility of Segmental Longitudinal Strain Measurement: A Report From the EACVI-ASE Strain Standardization Task Force. JACC Cardiovasc Imaging. 2017; 11(1):15-24. DOI: 10.1016/j.jcmg.2017.01.027. View

18.

Teske A, De Boeck B, Melman P, Sieswerda G, Doevendans P, Cramer M . Echocardiographic quantification of myocardial function using tissue deformation imaging, a guide to image acquisition and analysis using tissue Doppler and speckle tracking. Cardiovasc Ultrasound. 2007; 5:27. PMC: 2000459. DOI: 10.1186/1476-7120-5-27. View

19.

Atici A, Barman H, Durmaz E, Demir K, Cakmak R, Tugrul S . Predictive value of global and territorial longitudinal strain imaging in detecting significant coronary artery disease in patients with myocardial infarction without persistent ST-segment elevation. Echocardiography. 2019; 36(3):512-520. DOI: 10.1111/echo.14275. View

20.

Giridharan S, Karthikeyan S, Aashish A, Ganesh B, Prasath P, Usha P . Two-dimensional speckle tracking echocardiography derived post systolic shortening in patients with unstable angina and normal left ventricular systolic function. Anatol J Cardiol. 2021; 25(12):880-886. PMC: 8654016. DOI: 10.5152/AnatolJCardiol.2021.40931. View