Left ventricle longitudinal deformation assessment by mitral annulus displacement or global longitudinal strain in chronic ischemic heart disease: are they interchangeable?

J Am Soc Echocardiogr. 2009 Jul;22(7):823-30. doi: 10.1016/j.echo.2009.04.023. Epub 2009 Jun 7.


Background: Increasing infarct mass is associated with impaired prognosis in chronic ischemic heart disease. Global strain by echocardiographic assessment relates closely to infarct mass assessed by delayed enhancement magnetic resonance imaging but requires deformation analysis in a 16-segment model of the left ventricular. Mitral annular (MA) displacement reflects longitudinal left ventricular deformation and could provide similar information.

Methods: Global longitudinal strain and MA displacement by Doppler tissue imaging were assessed in 61 patients 9 months after first myocardial infarctions and compared with global myocardial infarct mass assessed using contrast-enhanced magnetic resonance imaging.

Results: Both indices significantly separated medium-sized infarcts from small or large infarcts (P < .05) and correlated significantly with global infarct mass (P < .01 for both). There was a good correlation between global strain and MA displacement (r = 0.65, P < .01). The sensitivities and specificities to identify myocardial infarcts differed only slightly among the indices, but global longitudinal strain tended to be the best.

Conclusions: Longitudinal deformation by global strain or MA displacement correlated well with myocardial infarct mass and could discriminate between different extents of myocardial infarctions. Global longitudinal strain tended to be better, especially for the identification of the smallest infarcts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Echocardiography / methods*
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Mitral Valve / diagnostic imaging*
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / diagnostic imaging*
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / diagnostic imaging*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / diagnostic imaging*