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Left ventricular ejection fraction and global longitudinal strain in patients with acute myocardial infarction after percutaneous revascularization: standard 2D vs triplane and 3D imaging

      Left ventricular ejection fraction (LVEF) is one of the main determinants in the prognostic of patients with myocardial infarction (MI) [
      • Marwick T.
      Ejection fraction pros and cons: JACC state-of-the-art review.
      ]. Three-dimensional (3D) measurement of the LV volumes and LVEF does not use geometric assumptions, thus this method is less sensitive to errors caused by foreshortening [
      • Hare JL
      • Jenkins C
      • Nakatani S
      • Ogawa A
      • Yu CM
      • Marwick TH
      Feasibility and clinical decision-making with 3D echocardiography in routine practice.
      ]. Furthermore, 3D transducers allow simultaneous orthogonal triplane imaging for all three standard apical views: apical long-axis (APLAX), 4-chamber (A4CH) and 2-chamber (A2CH). This allows measurements to be performed in the same cardiac cycle, therefore avoiding errors caused by irregular heart rhythms and foreshortening [
      • Nucifora G
      • Badano LP
      • Dall'Armellina E
      • Gianfagna P
      • Allocca G
      • Fioretti PM
      Fast data acquisition and analysis with real time triplane echocardiography for the assessment of left ventricular size and function: a validation study.
      ]. Moreover, it is necessary to identify subtle changes in the systolic function of the LV of these patients, which might occur even after successful primary revascularization. 2D speckle tracking (2DST) is a validated user-friendly method, which is less dependent on modifications in preload or afterload and has less inter-observer variability, with most data in literature on global longitudinal strain (GLS) [
      • Flachskampf FA
      • Schmid M
      • Rost C
      • Achenbach S
      • DeMaria A
      • Daniel WG
      Cardiac imaging after myocardial infarction.
      ].
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