Mecánica ventricular izquierda en pacientes con infarto agudo del miocardio

Abstract

SUMARY

Introduction The role of the new ecocardiographic techniques in patients with acute myocardial infarction is under development, and the measurement of left ventricular mechanics could predict the presence of significant coronary artery disease. Objectives To determine if the measure of global longitudinal and regional strain is useful to predict the presence of hemodinamically significant coronary artery disease. Methods It is a diagnostic test study, aimed to determine the operative characteristics of left ventricular mechanics compared to cardiac catheterism, which was considered the gold standard. 54 patients with a diagnosis of acute myocardial infarction who underwent cardiac catheterization were analyzed; transthoracic echocardiography was performed with measurement of global and regional longitudinal strains. Results Of 54 patients studied, 83% had hemodynamically significant coronary artery disease. The finding of a global longitudinal strain <-17.5 had a sensitivity of 85% and a specificity of 78% for predicting the presence of coronary artery disease; the left anterior descending artery regional longitudinal strain <- 17.4 had a sensitivity of 82% and a specificity of 44%; the circumflex artery strain had a sensitivity of 87% and a specificity of 37%, and for the right coronary artery a sensitivity of 73% and a specificity of 32% was found. Conclusions Echocardiography with measurement of ventricular mechanics in patients with acute myocardial infarction is useful for predicting the presence of hemodynamically significant coronary disease.