扩张型心肌病左室心肌质量与心室容积关系的研究

目的 探讨扩张型心肌病(DCM)左室心肌质量与心室容积关系.方法 运用M型、二维、实时三维超声心动图检测DCM患者及健康志愿者室间隔、左室后壁厚度及相对室壁厚度(即室壁厚度与左室舒张末内径的比值)、左室心肌质量(LVM)及左室心肌质量指数(LVMI)与左室舒张末容积(LVVd)及左室舒张末容积指数(LVVdI)的比值,分析DCM患者室壁厚度与左室内径、左室心肌质量指数与左室舒张末容积指数的关系.结果 DCM患者室间隔及左室壁厚度与正常人比较无明显差异,但其与左室内径的比值与正常人比较减小,左室心肌质量指数和左室舒张末容积指数都较正常人显著增加,而左室心肌质量指数与左室容积指数之比较正常人降低.结论 扩张型心肌病患者室壁相对变薄,左室心肌质量指数与左室容积指数之比较正常人降低,反映了扩张型心肌病心肌细胞肥大是以长径增大为主.超声心动图技术尤其是实时三维超声心动图能较准确测量左室心肌质量和左室容积,因而能反映扩张型心肌病左室心肌质量与心室容积的关系.     

超声心动图在诊断酒精性心肌病中的应用价值

目的探讨超声心动图在诊断酒精性心肌病中的应用价值。方法应用彩色多普勒超声心动图检测32例长期大量饮酒所致酒精依赖患者静息状态下的心内结构、血流和功能,从心脏各房室内径、室壁厚度、室壁回声、各室壁运动幅度、室壁增厚率、左室射血分数、各瓣膜形态结构、血流及功能等指标进行多方面观察,结合病史做出超声提示。结果左室舒张末期内径不同程度增大者32例,左室舒张末内径增大并左房内径增大者24例,以左心室增大为主的全心增大者6例,左室壁对称性轻度肥厚者9例,左室心肌内出现散在斑点状中强回声17例,左室心内膜增厚,回声增强10例,左心功能减低者20例(62.5%),左心功能减低合并不同程度肺循环高压者4例,左心增大伴左室心尖部附壁血栓者1例。结论超声心动图在酒精性心肌病的诊断中具有重要的临床应用价值,是临床医师诊断酒精性心肌病的重要辅助检查手段。     

扩张型心肌病和缺血性心肌病的彩色多普勒超声鉴别诊断分析

目的:回顾性分析彩色多普勒超声在鉴别诊断扩张型心肌病(dilated cardiomyopathy, DCM)和缺血性心肌病(ischemic cardiomyopathy, ICM)中的价值。方法:收集2020年1月至2022年12月期间在本院住院治疗的22例DCM患者临床资料,40例ICM患者临床资料,对两组患者病史资料进行回顾性分析。运用彩色多普勒超声检查比较两组患者心脏形态、心功能相关指标、心脏瓣膜反流情况,分析DCM和ICM典型超声影像图。结果:DCM患者左心室形态改变以球形为主占比72.73%(16/22),室壁运动以弥漫性减弱为主占比68.18%(15/22);ICM患者左心室形态改变以圆拱门形为主占比67.50%(27/40),室壁运动以节段性减弱为主占比82.50%(33/40),两组彩色多普勒超声心脏形态比较差异有统计学意义(P<0.05);两组每搏输出量比较无明显差异(P>0.05),而DCM组左室射血分数显著低于ICM组,左室舒张末期内径、左室舒末期容积、左室收缩末容积和右室舒张末内径均明显高于ICM组,DCM组二尖瓣、三尖瓣、主动脉瓣轻度反流比例均...     

斑点追踪显像评价扩张型心肌病患者左室扭转

目的：应用斑点追踪显像评价扩张型心肌病患者左室扭转以及其与左室收缩功能之间的关系。方法：获取30例扩张型心肌病患者与30例正常人的标准短轴左心室基底部、心尖部的图像，应用斑点追踪显像测量各个水平峰值旋转角度及旋转率，比较扩张型心肌病患者与正常人之间的差异，以及分析左室扭转与左室舒张末期、左室收缩末期容积及射血分数之间的关系。结果：扩张型心肌病组中峰值旋转角度、旋转率与左室扭转明显减低，左室扭转与左室舒张末期容积、左室收缩末期容积呈负相关，与左室射血分数呈正相关。结论：扩张型心肌病患者的左室扭转运动严重受损，从而引起收缩功能减退。     

左室壁运动同步性的实时三维超声心动图定量研究

目的应用实时三维超声心动图(RT-3DE)定量评价正常人及心力衰竭患者左室壁运动的同步性。方法采用实时三维超声心动图技术检测24例正常人、16例扩张型心肌病及27例心肌梗死患者左室壁各节段达舒张期最大容积时间以及收缩期最大射血分数时间。结果心肌梗死组与正常组的左室壁从第一个节段达舒张期最大容积到最后一个节段达舒张期最大容积的时相段在一个心动周期中分别占(12.42±4.47)%和(7.34±2.26)%,心肌梗死组较正常组显著延长(P<0.05);扩张型心肌病组与正常组的左室壁从第一个节段达最大射血分数到最后一个节段达最大射血分数的时相段在一个心动周期中分别为(17.20±6.48)%和(6.11±1.49)%,扩张型心肌病组与正常组相比差异有显著性(P<0.05)。结论左室壁各节段达舒张期最大容积及达收缩期最大射血分数并非在一个时间点,而是在一个时间段内,有先后之分;心肌梗死患者和扩张型心肌病患者该时间段延长,室壁运动的同步性下降。     

孤立性左心室心肌致密化不全与特发性扩张型心肌病超声心动图特征的对比分析

目的对比分析孤立性左心室心肌致密化不全(INCLVM)与特发性扩张型心肌病(IDCM)的超声心动图特征,探讨二者的鉴别诊断标准。方法10例INCLVM和15例IDCM患者行常规超声心动图检查二维超声测定室间隔与左室后壁基底段厚度、左室前后径(D)与左室长径(L)比值、左房前后径(LAd),双平面Simpson方法计算左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF);彩色多普勒血流显像评价各瓣膜口反流及程度;脉冲多普勒测定二尖瓣血流图评价左室舒张功能状况。将左室室壁分为9个节段,应用目测法确定肥大肌小梁所在节段及运动减弱节段。分别测定收缩末期和舒张末期心尖段肥大肌小梁厚度(Tt)与室壁厚度(Tw)比值。结果尽管INCLVM与IDCM患者球形重构(D/L)的程度是相似的,但是与IDCM患者相比,INCLVM患者具有更厚的室壁厚度,更小的LAd、LVESV和LVEDV,更高的LVEF,更低的二尖瓣反流及程度,更好的左室舒张功能状况。与IDCM患者相比,INCLVM患者肥大肌小梁所在节段分布范围较广、数目较多,而运动减弱节段则较少。收缩末期Tt/Tw较舒张末期Tt/Tw可以更准确地对IDCM与INCLVM进行鉴别诊断。结论INCLVM与IDCM超声心动图特征具有较多差异,综合考虑各个差异有助于对两者进行准确的鉴别诊断。     

声学定量技术评价缺血性心肌病患者左心功能

目的　探讨声学定量（AQ）技术在测定缺血性心肌病(ICM)患者左心功能中的临床应用价值。方法　测量24例ICM患者和30例正常人的左室舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、峰值充盈率(PFR)、峰值排空率(PER)、峰值充盈时间(TPFR)。结果　ICM组左室EDV为(120.08±24.50)ml,ESV为(79.78±17.38)ml,明显高于正常组(P<0.001),ICM组左室收缩功能指标EF为(33.19±8.50)%,PER为(2.59±0.63)ml/s,较正常组明显降低(P<0.001)。ICM组的左室舒张功能指标PFR为(2.62±0.52)ml/s,较正常组明显降低;TPFR为(207.63±45.76)ms,较正常组明显延长(P<0.001)。结论　AQ技术是测定ICM患者左心功能的一项简便实用的新方法。     

扩张型心肌病心电图与超声心动图相关性分析

回顾性分析2009年12月～2010年12月我院具有完整的心电图及超声心动图资料的62例扩张型心肌病患者的临床资料,比较扩张型心肌病患者心电图与超声心动图之间的相关性。结果患者QRS时限延长明显延长,窦性心律者PR间期为140.8～308.5(平均195.2±32.3)ms。患者心率与左室舒张末内径呈正相关;QRS时限与左室舒张末内径和左室收缩末内径呈正相关;Rw与左室后壁厚度呈正相关。心电图和超声心动图检查在扩张型心肌病的诊断和病情判断中具有重要的临床意义。     

实时三维超声心动图评价左室重构心功能的初步探讨

目的探讨实时三维超声心动图(RT-3DE)评价重构左室收缩功能的方法及可行性. 方法对26例不同病因所致左室形态重构的患者,应用RT-3DE采集左室腔立体数据库,测量左室舒张末期容积(EDV)、收缩末期容积(ESV)和左室射血分数(LVEF).同时应用二维超声(2DE)双平面Simpson's法和M型(ME)Teichholz法分别测量左室EF值.在心尖四腔、三腔和两腔心切面上,用ME记录二尖瓣瓣环在后间隔、侧壁、后壁、前间隔、下壁、前壁六个位点上运动的平均距离.分别比较RT-3DE与2DE、ME测值的相关性. 结果 RT-3DE能显示完整左室腔的立体形态.RT-3DE测定的LVEF值与二尖瓣瓣环运动的平均距离之间有很好的相关性(r＝0.9045,P<0.001),与二维法及M型法测量值之间相关性较低(r＝0.7355,r＝0.7218,P<0.01). 结论 RT-3DE为定量分析左室容积和收缩功能提供了一种无创的,准确可信的新途径.     

缺血性心肌病与扩张型心肌病超声心动图的鉴别诊断

目的：研究彩色多普勒超声心动图对缺血性心肌病（ICM）与扩张型心肌病（DCM）的鉴别诊断。方法：对经临床确诊的扩张型心肌病80例、缺血性心肌病65例的超声心动图资料进行对比分析。结果：DCM的多个房室腔扩大,室壁变薄及弥漫性运动减低,多瓣膜返流且程度高,收缩功能降低明显,舒张功能可正常。结论：ICM以左心室增大为主,室壁运动减低呈阶段性,常伴有室间隔增厚,单组瓣膜返流且程度轻,左室舒张功能障碍。     

屏气磁共振电影成像对55岁以上健康成年人左心室功能的评价

目的采用屏气磁共振电影成像的方法,建立55岁以上健康成年人左心室功能参数的参考值范围.方法对55名55岁以上健康成年人行左心室短轴位电影成像,用心功能软件勾画心内外膜边界,计算左心室整体和局部功能指标.结果左心室整体功能指标:舒张末期容积:(74.4±11.3) ml; 收缩末期容积:(26.8±7.0) ml;每搏射血量:(47.5±7.0) ml;射血分数:(64.2±5.7)%;舒张末期质量:(51.5±11.8) g;收缩末期质量:(76.5±14.7) g.获得心尖层面前壁、侧下壁、室间隔和乳头肌、基底层面室壁、室间隔的舒张末期,收缩末期室壁厚度,室壁增厚率,室壁运动的参考值范围.结论建立了55岁以上健康成年人左心室整体和局部功能参数的参考值范围,为冠心病人心功能异常的判定提供参考标准.     

Impact of presence of abnormal wall motion on echocardiographic determination of left ventricular function with automated boundary detection technique: re-evaluation

It is still unclear whether echocardiography with an automated boundary detection technique (ABD) can accurately determine the left ventricular (LV) volume and function particularly in the presence of LV wall asynergy. We intended to re-evaluate the reliability and application of the ABD, which was based on the acoustic quantification technique (Sonos 2500, Hewlett Packard) for the LV volume measurement in patients without or with LV wall asynergy. A total of 80 patients (mean age 56 years) who underwent left ventriculography (LVG) were divided into two groups. The group A consisted of 29 patients with normal LV wall motion and the group B consisted of 51 patients with generalized or regional LV wall motion abnormality. In group A patients, the LV end-diastolic volume (LVEDV) was 96 ± 25 ml by ABD and 112 ± 33 ml by LVG and those of LV end-systolic volume (LVESV) were 44 ± 14 ml by ABD and 48 ± 17 ml by LVG, thus resulting in the underestimation of LV volume by 12% in average. Under these conditions, the LV ejection fraction (LVEF) by ABD, 54 ± 8%, correlated well with that by LVG, 58 ± 7%. Although underestimation of LV volume by 17% in average also occurred in groups B (N.S.), LVEF was found to correlate well with that by LVG; 27 ± 8% vs 30 ± 11% (r=0.87, SEE=3.1%) for 21 patients with the generalized LV asynergy; 39 ± 10% vs 39 ± 12% (r=0.86. SEE=3.3%) for 30 patients with the regional LV asynergy. These results demonstrate the feasibility of the ABD in determining the LVEF, although underestimation can occur in measuring the absolute LV volume in patients with or without LV asynergy.     

Value of low-dose echodobutamine in the diagnosis of patency of the infarct related coronary artery

The resumption of contractility of asynergic segments in survivors after acute myocardial infarction (AMI) may be detected in viable myocardial areas. We have correlated the detection of viable myocardium, assessed with low dose dobutamine testing, with coronary angiography and clinical outcome in 66 consecutive survivors of AMI using the echocardiographic evidence of left ventricular wall motion abnormalities. The test enabled the identification of two groups: group A, comprising 32 patients (pts) demonstrating wall motion recovery at dobutamine infusion and group B, comprising 34 pts without wall motion recovery. The mean basal asynergy score index was 5.8±4.2 in group A and 6.0±4.2 in group B (p = ns). With dobutamine testing the score decreased to 2.8±3.6 in group A (p < 0.001 with respect to basal value), while it did not change significantly in group B. Left ventricular end diastolic volume (ml) was similar in the two groups (114±35 vs 107±79, p = NS). The infarct related artery (IRA) patency rate was 87.5% in group A, vs 26.5% in group B (p < 0.001). After a mean follow-up of 11±5 months, group A pts had basal asynergy score improvement (2.6±3.1, p < 0.001) and mild left ventricular end diastolic volume (ml) reduction, (108±32, p = NS), while group B pts had left ventricle end diastolic volume enlargement (130±38, p < 0.05), without score asynergy modification. Moreover all pts who experienced heart failure at follow-up were in group B. In our study, wall motion recovery with low dose dobutamine testing detects IRA patency after a first AMI (sensitivity 76%, specificity 86%, diagnostic accuracy 80%, positive predictive value 87%, negative predictive value 73%). IRA patency seems to be related to left ventricular volume reduction and wall motion improvement at follow-up. Low dose dobutamine echocardiography could be useful in detecting pts at risk of left ventricular enlargement after a first AMI.     

Influence of propranolol infusion on cyclic variation of myocardial integrated backscatter in hypertrophic obstructive cardiomyopathy

It has been demonstrated that cyclic variation, assessed by myocardial integrated backscatter, reflects regional myocardial contractile function. The aim of this study was to investigate the influence of administration of β-blocker propranolol on cyclic variation in patients with hypertrophic cardiomyopathy and persistent left ventricular (LV) pressure gradient and to test the hypothesis that the reduction of LV pressure gradient would be related to the change in regional contractile function. Before and after 2 mg propranolol infusion, transthoracic echocardiography with integrated backscatter analysis was performed on 11 patients (8 men and 3 women, mean age 54 ± 12 years old). Integrated backscatter curves were obtained from the ventricular septum and LV posterior walls. With propranolol infusion, there was a significant reduction of LV fractional shortening (0.39 ± 0.08 to 0.34 ± 0.09, P < .01) and LV pressure gradient (83 ± 40 mm Hg to 42 ± 32 mm Hg, P < .001). In the posterior wall, the magnitude of cyclic variation significantly decreased (7.1 ± 2.2 dB to 5.6 ± 1.8 dB, P < .01), whereas in the septum, no apparent change in this parameter was observed (5.8 ± 2.1 dB to 4.7 ± 1.9 dB). Our findings suggest that in this form of cardiomyopathy, (1) the posterior wall myocardium is more susceptible to negative inotropic effects than the septum; (2) the reduction of LV pressure gradient is not related to that of regional wall motion; and (3) poor response of the ventricular septum is possibly because of more severe myocardial disarray and hypertrophy. (J Am Soc Echocardiogr 2002;15:1251-55.)     

Pacing within the Ischemic Area Significantly Decreases the Left Ventricular Ejection Fraction during Experimental Acute Myocardial Infarction

Background: The aim of this study was to examine the effects on left ventricular (LV) function of LV apical or/and lateral wall pacing during an experimental acute myocardial infarction. Methods: In 12 anesthetized pigs, epicardial LV pacing at the apex or lateral wall, or at both sites simultaneously, was performed before and after left anterior descending (LAD) ligation. Data concerning LV function were obtained by two‐dimensional echo during spontaneous sinus rhythm (SR) and during pacing before and 15, 45, 60, and 90 minutes after LAD ligation. Results: Before ligation of the LAD, pacing at the lateral wall (48.04 ± 6.25%) or both sites (45.71 ± 6.31%) reduced the LV ejection fraction (EF) significantly (P < 0.01) in comparison to SR (55.44 ± 4.10%). However, during pacing at the apex (50.19 ± 6.50%), the reduction was not significant. After LAD ligation, the EF during lateral pacing (43.02 ± 7.71%) was significantly higher than during apical pacing (38.78 ± 8.26%, P < 0.04) but was not significantly different from that during dual‐site pacing (41.65 ± 8.69%). Conclusions: Pacing within the ischemic LV apical zone after LAD ligation impairs left ventricular ejection fraction, as compared with pacing the nonischemic LV lateral wall, and should therefore be avoided in clinical settings where the LV pacing site may be chosen. (PACE 2011; 63–71)     

Evaluation of cardiac function by echo-Doppler studies in critically ill patients

Measurements of stroke volume (SV) by echo-Doppler techniques (2D-echocardiography, continuous and pulsed Doppler) were compared to those obtained by thermodilution in 116 critically ill patients. The best correlation was obtained with pulsed Doppler positioned in the left ventricular (LV) outflow (r=0,78, p<0.001). In a subgroup of 12 patients who had LV ejection fraction < 60% and LV end-diastolic pressure > 15 mmHg, we also measured the peak aortic blood velocity (PABV) and acceleration (PABA) by continuous and pulsed Doppler as indexes of myocardial contractility before coronary artery bypass graft. When compared to healthy volunteers, these patients had decreased PABV and PABA, measured by continuous Doppler (91±16 vs 79±9 cm/s, p<0.05 and 913±202 vs 660±149 cm/s/s, p<0.05, respectively). These data therefore indicate that in critically ill patients pulsed Doppler placed in the LV outflow is an adequate echo-Doppler technique to measure SV, while continuous Doppler placed in the suprasternal notch can be used to assess LV performance.     

Adenosine infusion to patients with ischaemic heart disease may provoke left ventricular dysfunction detected by echocardiography

Summary. Infusion of the endogenous vasodilator adenosine to patients with ischaemic heart disease (IHD) frequently provokes myocardial ischaemia, possibly caused by a coronary steal. The aim of this study was to detect the occurrence and incidence of disturbances in left ventricular (LV) wall motion and Doppler indices of altered LV function during infusion of adenosine. Thirty-seven patients (six female) aged 37–74 years with IHD, verified by coronary angiography, were given up to 200 μg kg^-1 min^-1 (mean 155 ± 5) adenosine i.v. for 18 ± 1 min. LV wall motion was monitored by two-dimensional echocardiography (2D-echo). Doppler spectral signal was obtained from the mitral blood flow. All but six of the patients experienced angina pectoris of habitual character in connection with the adenosine infusion. Heart rate increased by 22 ± 1 beats min^-1, systolic blood pressure was unchanged, but diastolic blood pressure decreased slightly. 2D-echo revealed severe regional LV wall motion disturbances already in the basal state in 17 patients. During infusion of adenosine, these abnormalities were aggravated and disturbances also occurred in another 15 patients. Thus, adenosine increased the sensitivity for IHD in this selected material from 49 to 89%. In all, the mean index of wall motion abnormalities increased from 5·1 ± 1·1 to 10·1 ± 1·4 (P< 0·001). The diastolic LV filling characteristics, as evaluated by the Doppler A/E ratios, were of limited value for determination of IHD grade. It is concluded that infusion of adenosine to patients with IHD frequently elicits myocardial ischaemia with disturbances in LV function, and offers an alternative to exercise for stress echocardiography.     

Balloon pulmonary angioplasty improves interventricular dyssynchrony in patients with inoperable chronic thromboembolic pulmonary hypertension: a cardiac MR imaging study

To use cardiac magnetic resonance imaging (MRI) to investigate the effect of balloon pulmonary angioplasty (BPA) on interventricular dyssynchrony and its associations with ventricular interaction, which impairs LV function in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). This prospective observational study was approved by our institutional review board. Cardiac MRI and right heart catheterization were conducted before BPA sessions and at the follow up after BPA in 20 patients with CTEPH. We measured right ventricular (RV) and left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) using MRI. For the LV and RV free walls, the time to peak (T_peak) of circumferential strain was calculated as a parameter for interventricular dyssynchrony. Following BPA, the RV-EDV and -ESV were significantly decreased, and the RVEF was significantly increased. Conversely, BPA led to significantly increased LV EDV and SV without changing LVESV. The left-to-right free wall delay (L–R delay) in T_peak strain decreased from 105?±?44 ms to 47?±?67 ms (p?<?0.001). Increased LV EDV (r?=?0.65, p?<?0.01), SV (r?=?0.74, p?<?0.001) and 6-minute walk distance (6MWD) (r?=?0.54, p?<?0.05) were correlated to the reduction in L–R delay. In patients with inoperable CPEPH, BPA improved interventricular dyssynchrony, which was strongly associated with increased SV and 6MWD. The assessment of interventricular dyssynchrony using cardiac MRI has an important role in evaluating ventricular interaction, which reduces LVSV and exercise tolerance.     

实时三维超声心动图对比评价正常右心室及左心室功能

目的 观察利用实时三维超声心动图(RT-3DE)评估、比较成年人正常心脏左右心室的可行性,并探讨左右心室之间的关系.方法 应用RT-3DE全容积成像采集58名心脏正常成年人的心脏三维数据,在TomTec工作站中分析获得右心室舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)和射血分数(EF);在Qlab工作站中分析获得左心室舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)和射血分数(EF).结果 右心室EDV[(85.84±20.82)ml]、ESV[(41.87士10.48)ml]分别大于左心室EDV[(69.37士17.83)ml]、ESV[(26.46±8.26) ml](P均＜0.001),而右心室EF[(50.94士5.57)％]小于左心室EF[(61.97±6.48)％,P＜0.001].左心室SV[(42.91±11.72) ml]与右心室SV[(43.96±12.15) ml]差异无统计学意义(P=0.273).左右心室的对应参数均有相关性.结论 RT-3DE是评估左右心室容积和功能的可行方法,且其相应参数在左右心室间是相关的.     

Longitudinal left ventricular function is globally depressed within a week of STEMI

Sixty percent of stroke volume (SV) is generated by atrioventricular plane displacement (AVPD) in a healthy left ventricle (LV). The aims were to determine the effect of ST‐elevation myocardial infarction (STEMI) on AVPD and contribution of AVPD to SV and to study the relationship between AVPD and infarct size (IS) and location. Patients from CHILL‐MI and MITOCARE studies with cardiovascular magnetic resonance within a week of STEMI (n = 177, 59 ± 11 years) and healthy controls (n = 20, 62 ± 11 years) were included. Left ventricular volumes were quantified in short‐axis images. AVPD was measured in six locations in long‐axis images. Longitudinal contribution to SV was calculated as AVPD multiplied by the short‐axis epicardial area. Patients (IS 17 ± 10% of LV) had decreased ejection fraction (48 ± 8%) compared to controls (60 ± 5%, P<0·001). Global AVPD was decreased in patients (11 ± 2 mm versus 15 ± 2 mm in controls, P<0·001) and this held true for both infarcted and remote segments. AVPD contribution to SV was lower in patients (58 ± 9%) than in controls (64 ± 8%) (P<0·001). There was a weak negative correlation between IS and AVPD (r²=0·06) but no differences in global AVPD linked to infarct location. Decrease in global and regional AVPD occur even in remote myocardium within 1 week of STEMI. Global AVPD decrease is independent of MI location, and MI size has only minor effect. Longitudinal pumping is slightly lower compared to controls but remains to be the main component to SV even after STEMI. These results highlight the difficulty in determining infarct location and size from longitudinal measures of LV function.