Turk Kardiyol Dern Ars. 2020; 48(3): 255-262 | DOI: 10.5543/tkda.2019.36422
Relationship between the infarct localization and left ventricular rotation parameters following acute ST-segment elevation myocardial infarction
, Cafer Zorkun4
, Hasan Deniz Demir2
, Birol Topçu3
, Ender Emre1
, Nihal Özdemir51
Department of Cardiology, Çorlu State Hospital, Tekirdağ, Turkey2
Department of Cardiology, Trakya University Faculty of Medicine, Edirne, Turkey3
Department of Nuclear Medicine, Tekirdağ State Hospital, Tekirdağ, Turkey4
Department of Biostatistics, Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey5
Department of Cardiology, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
OBJECTIVE This study was an investigation of the role of left ventricular (LV) apical rotation seen in the early period after myocardial infarction (MI) in predicting infarct localization.
METHODS A total of 124 patients with a ST-Segment elevation myocardial infarction (STEMI) diagnosis who underwent primary percutaneous coronary intervention (PCI) and 50 healthy volunteers with similar demographic characteristics were included in the study. The relationship between 2-dimenstional speckle tracking echocardiography (STE)-guided LV apical rotation angle measurements and technetium-99m sestamibi-single-photon emission computed tomography (SPECT)-guided infarct localization was evaluated. Conventional echocardiography and STE were performed on average 2 days after PCI, and gated SPECT myocardial perfusion imaging (MPI) was performed within an average of 60 days.
RESULTS The apical rotation angle was lower in patients with an anterior MI compared with those who had an inferior MI and the control group (AntMI-InfMI: 6.51±2.4°, AntMI-Control: 13.20±2.5°, InfMI-Control: 14.3±2.1°; p value: 0.00, 0.00, 0.15, respectively). SPECT MPI analysis revealed the presence of an LV apical scar in all patients with acute anterior MI, but only 14 of those with inferior MI group (usually the inferoapical wall). The apical rotation angle recorded in patients with apical scar was lower than that of the patients without apical scar (7.6±2.8° and 14.5±2°, respectively; p=0.00). Receiver operating characteristic curve analysis yielded an area under the curve for apical rotation of 0.799 (p<0.01). The optimal cutoff value of 12.1° had a sensitivity of 78.3% and a specificity of 68.2% for predicting LV apical scar following STEMI.
CONCLUSION Detection of apical rotation angle decrease in the early period after STEMI may be useful in predicting extension of infarct scarring to the LV apex.
Apical rotation, infarct location; infarct size; left ventricular torsion.
How to cite this article
Aykut Demirkiran, Cafer Zorkun, Hasan Deniz Demir, Birol Topçu, Ender Emre, Nihal Özdemir. Relationship between the infarct localization and left ventricular rotation parameters following acute ST-segment elevation myocardial infarction. Turk Kardiyol Dern Ars. 2020; 48(3): 255-262
Corresponding Author: Aykut Demirkiran, Türkiye