Comparison of 2D Echocardiography Speckle Tracking and Cardiac Magnetic Resonance Feature Tracking for Prediction of LV Remodeling in Patients with ST-Elevation Acute Myocardial Infarction

Document Type : Original Article

Authors

Cardiology Department, Al-Azhar University, Al-Mokhaym Al-Daem Street, Nasr City, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446656

Abstract

Background: LV global longitudinal strain (GLS) by 2-dimensional speckle tracking echocardiography (2DSTE) is the most widely used strain parameter in clinical practice. CMR feature tracking (CMRFT) is a strain modality that is quite new and is being prepared for clinical implementation. One of the clinical applications of strain we worked on is LV remodeling prediction in post-STEMI patients. We compare both techniques and study the connection between LV remodeling and strain values determined by both methods.
Aim: To compare LV GLS by 2D STE versus CMRFT in patients with acute ST-elevation myocardial infarction (STEMI), and to validate the assumption linking GLS to LV remodeling following STEMI.
Methods: This prospective, non-randomized cohort study was conducted on 53 patients (51 ± 12 years old, 85% males) with STEMI who underwent primary PCI or pharmaco-invasive strategy between December 2022 and December 2024. Strain analysis was done before discharge using 2D STE and CMRFT. 2nd visit CMR was done after 3 months to detect the occurrence of LV remodeling.
Results: CMRFT measurements are well correlated with 2D STE in deformation quantification (r = 0.66). Impaired GLS in 2D STE or CMRFT after STEMI shows a good correlation with the occurrence of LV remodeling.
Conclusion: CMRFT is comparable to 2D STE in myocardial strain analysis measurements. GLS measured by STE or CMRFT during acute STEMI patients can be a valuable tool for predicting future LV remodeling. CMRFT was more reliable than STE in predicting the occurrence of LV remodeling.
 

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