Comparing 2D and 3D Echocardiography to Cardiac MRI for Detecting Left Ventricular Remodeling in Acute ST-Elevation Myocardial Infarction Patients after PCI in the Short Term. A Prospective Observational Study

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Authors: Mahmoud Abdelshafy, Ekram Sadek, Hanan Kassem, Samya Sharaf-Eldeen, and Enas Daraz
Page Range: 237-250
Published in: World Heart Journal, 15#4 (2023)
ISSN: 1556-4002

Table of Contents

ABSTRACT

Background: After acute myocardial infarction (AMI), the left ventricle undergoes infarct expansion, hypertrophy, and dilatation. Two-dimensional echocardiography (2D echo) has been used to analyze the geometry of the LV function. However, a 3D echo shows up to three times more accuracy than a 2D echo. This study aims to evaluate the accuracy of 2D echo and 3D echo in detecting left ventricular remodeling in STEMI patients after percutaneous coronary intervention (PCI), and to compare their accuracy to that of cardiac magnetic resonance imaging (CMR) in the short term.

Study settings: This study was conducted at the cardio-vascular department of Tanta University Hospital.

Methods: This prospective observational study was conducted on 50 patients with Acute ST-elevation myocardial infarction undergoing PCI at the cardiovascular department of our University Hospital.

Results: Our study comprised 50 patients with average age of 60.28 ± 10.43 years. The comparison between 2D and 3D echocardiographic parameters showed a lack of agreement between the two devices regarding end-diastolic volume (EDV), end-systolic volume (ESV), EDV index, ESV index, and ejection fraction. The study compared CMRI and 3D echocardiographic parameters and found good agreement and reliability between the two devices for EDV, EDV index, ESV, ESV index, and ejection fraction.

Conclusion: Nearly 30% of ST-segment elevation AMI patients treated with primary PCI experienced LV remodeling. Good agreement was found between CMR and 3D echo parameters, but poor agreement was found between 2D echo and 3D echo and CMR. The 3D SI was the strongest predictor of subsequent remodeling and accurately identified patients likely to undergo LV remodeling after AMI. The 3D echo technique is cost-effective and ideal for assessing and stratifying risk, and for following-up with patients after AMI.

Keywords: Echocardiography; cardiac magnetic resonance imaging; ventricular remodeling, percutaneous coronary intervention; Myocardial infarction

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