Evaluation of myocardial mechanical changes in patients with acute myocardial infarction before and after percutaneous coronary intervention by speckle tracking technique

Objective To evaluate the changes of myocardial mechanics before and after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI) by ultrasonic speckle tracking technique, and investigate the recovery of left ventricular myocardium mechanics and the effects of common complications on the improvement of myocardial mechanics. Methods Sixty-two patients with AMI were examined by echocardiography within 12 hours, 1 week and 3 months after PCI. According to the complications the patients were divided into simple AMI group (21 cases), AMI with diabetes mellitus group (21 cases), and AMI with hypertension group (20 cases). Thirty healthy volunteers were selected as control group. Conventional echocardiographic parameters and left ventricular strain parameters were evaluated in all subjects. Results ①Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic volume (LVEDV), and left ventricular end-systolic volume (LVESV) in each AMI group before PCI were greater than the control group (P 0.05 ). ③The degree of improvement of global longitudinal and circumferential endocardial strain in AMI with diabetes group were less than those in simple AMI group(P<0.05). The degree of improvement of global longitudinal endocardial strain in AMI with hypertension group was less than that in simple AMI group (P<0.05). Conclusions Patients with AMI have poor myocardial mechanics before PCI, especially those with diabetes mellitus; myocardial mechanics improves significantly 3 months after PCI; diabetes mellitus or hypertension affectes the improvement of myocardial mechanics in patients with AMI after PCI. Key words: Echocardiography; Acute myocardial infarction; Speckle tracking; Myocardial mechanics