Objective To investigate the correlation between echocardiographic non-invasive assessment of myocardial work and late gadolinium contrast enhanced cardiac magnetic resonance (LGE-CMR) assessment of myocardial viability after ST-segment elevation myocardial infarction (STEMI)

and the difference in myocardial work parameters between the core zone and the remote zone of myocardial infarction. Methods STEMI patients who underwent primary percutaneous coronary intervention (PCI) were included. Several non-invasive myocardial work parameters were derived from speckle tracking strain echocardiography and sphygmomanometric blood pressure

e.g.: segmental myocardial work index (WIs)

segmental myocardial constructive work (CWs)

segmental myocardial wasted work (WWs) and segmental myocardial work efficiency (WEs). LGE was quantified to determine infarct transmurality and scar burden. The core zone was defined as the segment with the largest extent of transmural LGE and the remote zone as the diametrically opposed segment without LGE. Results A total of 61 patients

1037 myocardial segments were included in the analysis

of which 124 segments were transmural enhancement on LGE-CMR

425 segments were non-transmural enhancement

488 segments were no enhancement. Compared with the non-enhanced group

WIs

CWs

and WEs of the non-transmural enhancement group and the transmural enhancement group were significantly decreased

and WWs was significantly increased (all P<0.05). WIs

CWs and WEs were significantly negatively correlated with infarct transmurality

and WWs was significantly positively correlated with infarct transmurality (all P<0.05). Compared with the remote zone

WIs

CWs and WEs of the core zone were significantly decreased

and WWs was significantly increased (all P<0.05). Conclusions Non-invasive myocardial work parameters may serve as potential markers of segmental myocardial viability in post-STEMI patients who underwent primary PCI. Non-invasive myocardial work can also be utilized to characterize the remote zone

which is an emerging prognostic marker as well as a therapeutic target.