2Hacettepe Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye
3Department of Cardiology, Faculty of Medicine, University of Hacettepe, Ankara Turkey
4Department of Cardiology, Gülhane Military Medical Academy, Haydarpaşa Hospital, İstanbul-Turkey
5Department of Cardiology, Faculty of Medicine, University of Hacettepe, Ankara Turkey
6Department of Cardiology, Faculty of Medicine, University of Hacettepe, Ankara Turkey
7Cardiology Clinic, Develi State Hospital, Kayseri-Turkey
8Hacettepe Üniversitesi, Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye
Abstract
Objective: To evaluate the diagnostic value of mean annular velocity (MAV) and strain score index (SSI) for determination of the left ventricular systolic dysfunction in patients with first acute myocardial infarction (AMI). Materials and Methods: Seventy-one patients (55 male, mean age: 59±12 years) with first acute ST-elevation myocardial infarction and 30 healthy subjects were included in this cross-sectional and observational study. Echocardiography with tissue Doppler and strain analysis was performed during initial hospital admission. Peak systolic myocardial velocities were recorded from 4 different sites on the mitral annulus. A MAV value was calculated and the peak systolic strain values of 12 segments were measured and a mean SSI was calculated. ROC curve analysis was used in order to determine cut-off values for MAV and SSI. Results: The patients with AMI had a significantly reduced MAV compared with healthy subjects (5.52±1.78 cm/s vs 9.80±1.13 cm/s, p<0.001). In ROC analysis, a cut-off value of 8.41 cm/s (AUC 0.915, 95%CI 0.887-0.952, p<0.001) for MAV differentiated AMI patients from controls with 97.2% sensitivity and 93.3% specificity. The patients with AMI have also decreased SSI (11.23±2.83 vs 19.11±2.05, p<0.001). A cut-off value of 15.35% differentiated AMI patients from controls with 94.4% sensitivity and 100% specificity (ROC AUC 0.945, 95%CI 0.901-0.972, p<0.001). There was a good correlation between left ventricular EF and MAV (r=0.73, p<0.001) and SSI (r=0.66, p<0.001). Conclusion: The patients with first myocardial infarction have decreased mean systolic annular velocity and mean systolic strain score index.