Peak longitudinal strain most accurately reflects myocardial segmental viability following acute myocardial infarction - an experimental study in open-chest pigs

2D-STE strain was assessed in long- and short-axis following myocardial infarction in ten open-chest anesthetized pigs. Strain was defined according to systolic peak values. In segments displaying both negative and positive peaks, only the peak with the highest absolute value was utilized. Necrosis was measured by 2,3,5-triphenyltetrazolium chloride (TTC) staining and expressed as percent of each myocardial segment.Significant correlations were found between the extension of necrosis and all measured parameters of myocardial deformation (p？<？0.001), but was stronger for longitudinal strain (r2？=？0.52) than circumferential strain (r2？=？0.38) and radial strain (r2？=？0.23). The area under the receiver operator characteristic curve (AUC) for separating transmural necrotic segments (>50% necrosis) from predominantly viable segments (0–50% necrosis) was significantly larger for longitudinal strain (AUC？=？0.98, CI？=？0.97–1.00) when compared with circumferential strain (AUC？=？0.91, CI？=？0.84–0.97, p？<？0.05) and radial strain (AUC？=？0.90, CI？=？0.83 – 0.96, p？<？0.01), indicating a stronger ability of longitudinal strain to identify segments with transmural necrosis.Peak strain values derived from 2D-STE correlate well with the extent of necrosis in myocardial segments following acute myocardial infarction. Longitudinal strain most accurately reflects myocardial segmental viability in this setting.Two-dimensional speckle tracking echocardiography (2D-STE) is an increasingly recognized technique that measures myocardial deformation by automatic tracking of interference patterns from conventional gray scale B-mode images during the cardiac cycle. In contrast to tissue Doppler derived strain, 2D-STE has the advantage of being relatively independent of insonation angle, and can therefore assess motion in three dimensions [1,2]. 2D-STE has been validated against sonomicrometry in experimental studies of myocardial ischemia [2,3] and magnetic resonance imaging in patients with ische