Background: While post-systolic shortening is a common finding on 2D speckle tracking
by echocardiography, its significance for diagnosis relative to other imaging modalities
has not been defined
Methods: We studied 21 patients (14 males, mean age 56±14 years) with
echocardiography and positron emission tomography (PET). Longitudinal strain by 2D
speckle tracking (Echo pac PC GE medical) was performed in the standard 2, 3 and
4-chamber views. The patients also underwent PET resting rubidium and FDG cardiac
scan within two weeks of the echo study.Holosystolic stretch with post-systolic shortening
was defined as stretching of the myocardial segment >50% of the systolic time coupled
to shortening after aortic valve closure. PET studies were analyzed using a 17-segment
model as normal, hibernating or scarred myocardium
Results: Longitudinal strain by 2D speckle tracking was feasible in 316 out of 357
segments. Holosystolic stretch with postsystolic shortening occurred in 69 out of 82
scarred myocardial segments. It also occurred in 9 non-scarred segments. Specificity
and sensitivity of these findings were 96 % and 84% respectively, with positive, negative
predictive value and accuracy of 88%, 94%, and 93% respectively.
Conclusions: Holosystolic stretch with post systolic shortening is a highly specific and
fairly sensitive measure to identify scarred myocardial segments on 2D strain imaging