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Accuracy of three-dimensional systolic dyssynchrony and sphericity indexes for identifying early left ventricular remodelling after acute myocardial infarction [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-02844 | DOI: 10.14744/AnatolJCardiol.2019.02844  

Accuracy of three-dimensional systolic dyssynchrony and sphericity indexes for identifying early left ventricular remodelling after acute myocardial infarction

Arnas Karuzas, Egle Rumbinaite, Dovydas Verikas, Tomas Ptasinskas, Gintare Muckiene, Egle Kazakauskaite, Vytautas Zabiela, Renaldas Jurkevicius, Jolanta Justina Vaskelyte, Remigijus Zaliunas, Diana Zaliaduonyte-Peksiene
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

Background
Left ventricle (LV) geometry and dyssynchrony are associated with LV remodelling after acute myocardial infarction (AMI). The aim of this prospective study was to assess the diagnostic value of new three-dimensional echocardiography (3DE) parameters ((sphericity (SI) and systolic dyssynchrony indexes (SDI)) for prediction of LV remodelling after AMI and compare them with two-dimensional echocardiography (2DE) parameters.
Methods
2DE and 3DE were performed in 75 AMI patients within 3 days from the onset of MI and 6 months later. LV remodelling was defined as a ≥ 15% increase in the LV end-diastolic volume (EDV) at the follow-up. 3D SI was calculated by dividing EDV by the volume of a sphere whose diameter was derived from the major end-diastolic LV long axis. SDI was considered as a standard deviation of the time from cardiac cycle onset to minimum systolic volume in 16 LV segments.
Results
LV remodelling was identified in 34 patients (45%) using 2DE method and in 22 patients (29%) using 3DE method. Evaluated 3DE parameters such as EDV (AUC 0.742 with sensitivity 71%, specificity 79%), ESV (AUC 0.729 with sensitivity 69%, specificity 78%), SDI (AUC 0.777 with sensitivity 73%, specificity 77%) and SI had significant prognostic value for LV remodelling. According to the area under the ROC curve, the highest predictive value had 3D SI (AUC 0.957 with sensitivity 90%, specificity 91%).
Conclusions
3DE parameters, especially, 3D SI and SDI play an important role in prediction of LV remodelling after AMI and can be used in clinical practice.

Keywords: 3D echocardiography, systolic dyssynchrony index, sphericity index, left ventricular remodelling, myocardial infarction.




Corresponding Author: Arnas Karuzas, Lithuania


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