Validation of Longitudinal Peak Systolic Strain by Speckle Tracking Echocardiography With Visual Assessment and Myocardial Perfusion SPECT in Patients With Regional Asynergy

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Background: Automated function imaging (AFI) is a recently developed method of calculating the longitudinal peak systolic strains (LS) of the regional left ventricular (LV) wall using speckle tracking echocardiography and displaying them on a single bull's-eye map. The feasibility of AFI in patients with regional LV wall motion abnormalities caused by myocardial infarction (MI) was evaluated by comparison with visual assessment and myocardial perfusion single-photon emission computed tomography (SPECT). Methods and Results: Segmental LS was measured by AFI in 60 patients with MI (67±11 years) and 58 controls (71±9 years). Wall thickening (WT) was measured by SPECT in 20 patients with MI. There was a strong positive linear relationship between the wall motion score index by expert visual assessment and global LS. The receiver-operating characteristic analysis revealed the best cutoff value of 11% <LS to identify hypokinetic segments. The overall accuracy of wall motion scoring by LS in the 2,006 segments was 96.8% (κ=0.90) compared with visual assessment. The correlation coefficient between LS and WT was R²=0.65 in the 340 segments. Conclusions: Assessment of LV regional asynergy by AFI showed good agreement with visual and SPECT assessments. AFI is clinically useful for quantitative assessment of LV regional wall motion abnormalities.