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European Heart Journal Advance Access originally published online on December 21, 2006
European Heart Journal 2007 28(2):269; doi:10.1093/eurheartj/ehl430
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Myocardial deformation to determine transmurality of myocardial infarction

Yan Zhang

Medicine
Division of Cardiology
University of California
San Francisco
CA
USA

John E. Sanderson

Department of Cardiology
University Hospital of North Staffordshire
Keele University School of Medicine
Stoke-on-Trent
UK
Tel: +44 178 2552387
E-mail address: john.sanderson{at}uhns.nhs.uk

We read with interest the article by Becker et al.1 in which they used speckle (or pixel) tracking echocardiography to measure deformation or strain in patients with myocardial infarction to determine transmurality. Their references to previous work in this area are a little disingenuous. They state that all three earlier studies were ‘experimental’ including our own.2 In fact our study was almost identical in design, including the use of ce-MRI, with similar results to their own and was not an experimental animal study. We examined consecutive myocardial infarction patients and used tissue Doppler rather than speckle tracking to measure strain rate. We found that a reduced strain (>–0.59 s–1) detected a transmural infarction with high sensitivity (91%) and specificity (96.4%) which is slightly better than Becker and his colleagues results with speckle tracking.1 Although there are theoretical advantages to speckle tracking particularly the lack of angle-dependency Doppler-based strain rate imaging is widely available and relatively easy to analyse. It is a pity that Becker and colleagues did not do a direct comparison of the two techniques to demonstrate that speckle tracking is indeed superior as they claim.

References

  1. Becker M, Hoffman R, Kuhl HP, Grawe H, Katoh M, Kramann R, Bucker A, Hanrath P, Heussen N. (2006) Analysis of myocardial deformation based on ultrasonic pixel tracking to determine transmurality in chronic myocardial infarction. Eur Hear J 27:2560–2566.[Abstract/Free Full Text]
  2. Zhang Y, Chan AKY, Yu CM, Yip GWK, Fung JWH, Lam WWM, So NMC, Wang M, Wu EB, Wong JT, Sanderson JE. (2005) Strain rate imaging differentiates transmural from non-transmural myocardial infarction. A validation study using delayed-enhancement magnetic resonance imaging. J Am Coll Cardiol 46:864–871.[Abstract/Free Full Text]

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This Article
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