Exploratory echocardiographic strain parameters for the estimation of myocardial infarct size in ST-elevation myocardial infarction

Varius Dannenberg, Finn Christiansen, Matthias Schneider, Stefan Kastl, Thomas Martin Hofbauer, Thomas Scherz, Julia Mascherbauer, Dietrich Beitzke, Christoph Testori, Irene Marthe Lang, Andreas Mangold

Research output: Journal article (peer-reviewed)Journal article

3 Citations (Scopus)


BACKGROUND: Outcome after ST-elevation myocardial infarction (STEMI) can be most reliably estimated by cardiac magnetic resonance (CMR) imaging. However, CMR is expensive, laborious, and has only limited availability. In comparison, transthoracic echocardiography (TTE) is widely available and cost-efficient.

HYPOTHESIS: TTE strain parameters can be used as surrogate markers for CMR-measured parameters after STEMI.

METHODS: TTE strain analysis was performed of patients included in a controlled, prospective STEMI trial (NCT01777750) 4 ± 2 days after the event. Longitudinal peak strain (LPS), post-systolic shortening, early systolic lengthening, early systolic lengthening time, and time to peak shortening were measured, and index parameters were computed. Global longitudinal strain (GLS) and ejection fraction (EF) were compiled. Parameters were correlated with CMR-measured variables 4 ± 2 days after STEMI.

RESULTS: In 70 STEMI patients, high quality CMR and TTE data were available. Highest correlation with CMR-measured infarct size was observed with GLS (r = 0.577, p < 0.0001), LPS (r = 0.571, p < 0.0001), and EF (r = -0.533, p < 0.0001). Highest correlation with CMR-measured area at risk was observed with GLS (r = 0.666, p < 0.0001), LPS (0.661, p < 0.0001) and early systolic lengthening index (r = 0.540, p < 0.0001). Receiver operating characteristics for the detection of large infarcts (quartile with highest infarct size) showed the highest area under the curve for LPS, GLS, EF, and myocardial dysfunction index. Multiple linear regression displayed the best association between GLS and infarct size.

CONCLUSION: Exploratory strain parameters significantly correlate with CMR-measured area at risk and infarct size and are of potential interest as endpoint variables in clinical trials.

Original languageEnglish
Pages (from-to)925-931
Number of pages7
JournalClinical Cardiology
Issue number7
Publication statusPublished - Jul 2021


  • Echocardiography
  • Humans
  • Magnetic Resonance Imaging, Cine
  • Myocardial Infarction/diagnostic imaging
  • Prospective Studies
  • Reproducibility of Results
  • ST Elevation Myocardial Infarction/diagnostic imaging


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