Advances in the Application of Non-Invasive Myocardial Work in Assessing Left Ventricular Function and Prognosis After Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction
DOI:
https://doi.org/10.54097/tpgv6e95Keywords:
Acute Myocardial Infarction, Noninvasive Myocardial Work, Percutaneous Coronary Intervention OperationAbstract
Timely assessment of left ventricular function, prognosis prediction, and subsequent adjustment of clinical treatment strategies are crucial for improving clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Traditional assessment methods, such as cardiac magnetic resonance imaging and conventional echocardiography, have limitations, including high cost, time consumption, or insufficient sensitivity. Non-invasive Myocardial Work (MW) technology, by combining speckle tracking and left ventricular pressure-strain loops, dynamically quantifies myocardial mechanical properties, providing a novel non-invasive approach for assessing AMI patients after PCI. This article analyzes recent literature, elaborates on the principles of MW technology and its application in left ventricular function evaluation, dynamic monitoring of postoperative myocardial function, and guiding clinical treatment decisions after PCI in AMI patients. It also discusses the current limitations of MW technology and its future prospects, aiming to explore the clinical value of MW technology in the assessment of AMI patients after PCI.
Downloads
References
[1] TSAO C W, ADAY A W, AlMARZOOQ Z I, et al. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association[J]. Circulation, 2023,147(8): e93-e621.
[2] DING J, SUN H G, LIU J, et al. Assessment of left ventricular myocardial work done by noninvasive pressure-strain loop technique in patients with essential hypertension[J]. Ann Noninvasive Electrocardiol, 2022,27(6): e12983.
[3] ZHONG X F, CHEN L X, LIU L X, et al. Early detect left ventricular subclinical myocardial dysfunction in patients with systemic lupus erythematosus by a left ventricular pressure-strain loop[J]. Lupus, 2022,31(5):596-605.
[4] LUO Q, SUN W, Li Z, et al. Biomaterials-mediated targeted therapeutics of myocardial ischemia-reperfusion injury[J]. Biomaterials, 2023,303:122368.
[5] KANG S X, MENG X M, LI J. Effect of Tirofiban Injection on vascular endothelial function, cardiac function and inflammatory cytokines in patients with acute myocardial infarction after emergency Percutaneous Coronary Intervention [J]. Pak J Med Sci, 2022,38(1):9-15.
[6] ZHUO M F, ZHANG K L, SHEN X B, et al. Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation[J]. World J Clin Cases, 2022,10(7):2106-2114.
[7] LIU X, ZOU Y, HUANG D, et al. Effect of evidence-based nursing combined with exercise rehabilitation in patients with acute myocardial infarction after percutaneous coronary intervention[J]. Am J Transl Res, 2022,14(10):7424-7433.
[8] RUSSELL K, ERIKSEN M, ABERGE L, et al. A novel clinical method for quantification of regional left ventricular pressure-strain loop area: a non-invasive index of myocardial work[J]. Eur Heart J, 2012,33(6):724-733.
[9] HE SL, HOU XT, SI XF, et al. Clinical application of ultrasonic noninvasive myocardial work detection technology in left ventricular systolic function before and after percutaneous coronary intervention forcoronary artery disease [J]. Chin Clin Med Imaging, 2022,33(06):396-400.
[10] LI X, CHEN H, HAN M, et al. Quantitative assessment of left ventricular systolic function in patients with systemic lupus erythematosus: a non-invasive pressure-strain loop technique [J]. Quant Imaging Med Surg, 2022,12(6):3170-3183.
[11] SAFFI H, WINSLOW U, SAKTHIVEL T, et al. Global constructive work is associated with ventricular arrhythmias after cardiac resynchronization therapy[J]. Eur Heart J Cardiovasc Imaging, 2023,25(1):29-36.
[12] LIN M, QIN Y, DING X, et al. Association between left ventricular geometry and global myocardial work in patients with heart failure with preserved ejection fraction: assessment using strain-pressure loop[J]. Int J Cardiovasc Imaging, 2023, 39(2):319-329.
[13] SABATINO J, DE ROSA S, LEO I, et al. Non-invasive myocardial work is reduced during transient acute coronary occlusion[J]. PLoS One, 2020,15(12): e244397.
[14] WELT F, BATCHELOR W, SPEARS J R, et al. Reperfusion Injury in Patients With Acute Myocardial Infarction: JACC Scientific Statement[J]. J Am Coll Cardiol, 2024,83(22):2196-2213.
[15] LIU YH,WANG F,YANG YJ,et al. Assessment of systolic function and myocardial perfusion after percutaneous coronary intervention in patients with acute myocardial infarction by left ventricular pressure-strain loop[J]. Chinese Journal of Ultrasonography, 2022,31(02):115-121.
[16] JIN W, WANG L, ZHU T, et al. Usefulness of echocardiographic myocardial work in evaluating the microvascular perfusion in STEMI patients after revascularization [J]. BMC Cardiovasc Disord, 2022,22(1):218.
[17] WANG XH,YE CW,TONG HS, et al. The value of noninvasive left ventricular pressure⁃strain loop in evaluating left ventricular function and left ventricular remodeling before and after percutaneous coronary artery intervention in patients with acute myocardial infarction[J]. The Journal of Practical Medicine,2024,40(20):2841-2847.
[18] DE PAULA LUSTOSA R, CHIMED S, YEDIDYA I, et al. Left ventricular myocardial work indices according to different remodeling patterns after st-segment elevation myocardial infarction[J]. Journal of the American College of Cardiology, 2021,77(0735-1097):1338.
[19] MEIMOUN P, ABDANI S, GANNEM M, et al. Usefulness of non-invasive myocardial work to predict left ventricular recovery and acute complications after acute anterior myocardial infarction treated by primary angioplasty[J]. European Heart Journal, 2020,41(0195-668X):0-0.
[20] DE PAULA LUSTOSA R, VAN DER BIJL P, KNUUTI J, et al. Regional left ventricular myocardial work index in culprit territory predicts early left ventricular remodelling in patients with st-segment elevation myocardial infarction[J]. European Heart Journal, 2020,41(0195-668X):0-0.
[21] WANG W, ZHAO H, WAN F, et al. Inhomogeneous Distribution of Regional Myocardial Work Efficiency Predicts Early Left Ventricular Remodeling After Acute Anterior Myocardial Infarction Treated With Primary Percutaneous Intervention[J]. Front Cardiovasc Med, 2022,9:922567.
[22] SUN S, CHEN N, SUN Q, et al. Association Between Segmental Noninvasive Myocardial Work and Microvascular Perfusion in ST-Segment Elevation Myocardial Infarction: Implications for Left Ventricular Functional Recovery and Clinical Outcomes[J]. J Am Soc Echocardiogr, 2023,36(10): 1055-1063.
[23] TIMÓTEO A T, BRANCO L M, GALRINHO A, et al. Global left ventricular myocardial work index and medium-term adverse cardiovascular events after ST-elevation myocardial infarction[J]. International Journal of Cardiology, 2024,0 (0167 -5273):131781.
[24] LEI Z, LI B, LI B, et al. Predictors and prognostic impact of left ventricular ejection fraction trajectories in patients with ST-segment elevation myocardial infarction[J]. Aging Clin Exp Res, 2022,34(6):1429-1438.
[25] ZHANG TT,LAN CF,LIN YF.Clinical Study on Assessing Left Ventricular Myocardial Work in Patients with Chronic Heart Failure Using Left Ventricular Pressure - Strain Loop[J].Prevention and Treatment of Cardiovascular Disease, 2020,10(27):22-24.
[26] ZHAO YJ, HE FR, HE W, et al. Value of non - invasive left ventricular myocardial work in the diagnosis of myocardial ischemia in coronary heart disease[J]. Chinese Journal of Clinical Medicine, 2024,31(03):411-419.
[27] HSU W, WARREN J, RIDDLE P. Multivariate Sequential Analytics for Cardiovascular Disease Event Prediction[J]. Methods Inf Med, 2022,61(S 02):e149-e171.
[28] SHINOHARA H, KODERA S, NAGAE Y,et al. The potential of the transformer-based survival analysis model, SurvTrace, for predicting recurrent cardiovascular events and stratifying high-risk patients with ischemic heart disease[J]. PLoS One, 2024,19(6):e304423.
[29] LIN Q, ZHAO W, ZHANG H,et al. Predicting the risk of heart failure after acute myocardial infarction using an interpretable machine learning model[J]. Front Cardiovasc Med, 2025,12: 1444323.
[30] LIANG Z, YANG Y, WANG F,et al. Assessing the early prognosis of heart failure after acute myocardial infarction using left ventricular pressure-strain loop: a prospective randomized controlled clinical study[J]. Quant Imaging Med Surg, 2024,14(2):1957-1970.
[31] WALD D S, MORRIS J K, WALD N J, et al. Randomized trial of preventive angioplasty in myocardial infarction[J]. N Engl J Med, 2013,369(12):1115-1123.
[32] IBANEZ B, JAMES S, AGEWALL S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2018,39(2):119-177.
[33] BEIJNINK C, THIM T, VAN DER HEIJDEN D J, et al. Instantaneous wave-free ratio guided multivessel revascularisation during percutaneous coronary intervention for acute myocardial infarction: study protocol of the randomised controlled iMODERN trial[J]. BMJ Open, 2021, 11(1): e44035.
[34] HE X T, ZHANG J, PAN Y, et al. Prediction of an impaired myocardial work using infarct size in acute myocardial infarction[J]. Coron Artery Dis, 2024,35(1):59-66.
[35] WANG X, PU J. Recent Advances in Cardiac Magnetic Resonance for Imaging of Acute Myocardial Infarction[J]. Small Methods, 2024,8(3): e2301170.
[36] MAHDIUI M E, VAN DER BIJL P, ABOU R,et al. Myocardial Work, an Echocardiographic Measure of Post Myocardial Infarct Scar on Contrast-Enhanced Cardiac Magnetic Resonance[J]. Am J Cardiol, 2021,151:1-9.
[37] HU X, ZHANG H, CAOBELLI F, et al. The role of deep learning in myocardial perfusion imaging for diagnosis and prognosis: A systematic review[J]. iScience, 2024,27(12): 111374.
[38] SUFIAN M A, NIU M. Hybrid deep learning for computational precision in cardiac MRI segmentation: Integrating Autoencoders, CNNs, and RNNs for enhanced structural analysis [J]. Comput Biol Med, 2025,186:109597.
[39] CLARK K, MCNAMARA R L. Is Left Ventricular Stroke Work Index Useful in the Cardiac Intensive Care Unit? [J]. Circulation: Cardiovascular Imaging, 2020,13(1941-9651):0-0.
[40] LANDRA F, CHIANTINI B, MANDOLI G E, et al. Left ventricular myocardial work indices and invasive measurement of stroke work: a correlation study[J]. European Heart Journal - Cardiovascular Imaging, 2022,23(2047-2404):0-0.
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

