Global Longitudinal Strain in Patients with ST-Elevation Myocardial Infarction Post-Percutaneous Coronary Intervention Using Speckle Tracking Echocardiography

Abstract

Background: Routinely, two-dimensional (2D) left ventricular ejection fraction (LVEF) is used to assess the left ventricular (LV) systolic function. Lately, global longitudinal peak systolic strain (GLPSS) has emerged to be a more sensitive tool for assessing LV systolic function. We aimed to assess the superiority of GLPSS by 2D speckle-tracking echocardiography in patients with ST-elevation myocardial infarction (STEMI) before and within 48 h after percutaneous coronary intervention (PCI) over 2D-LVEF calculated using the Simpson's biplane method of disks. Materials and Methods: A total of 70 patients with STEMI who underwent PCI were included in this study, which was conducted in the Department of Cardiology, MDM hospital, Jodhpur, Rajasthan, India, between November 2018 and February 2019. Patients having preexisting cardiomyopathy, moderate-to-severe valvular heart disease, morbid obesity, and poor echocardiographic window were excluded from the study. Echocardiography before and within 48 h of PCI was done. 2D-LVEF was calculated using Simpson's method. GLPSS was assessed using the automated function imaging technique. Results: Post-PCI GLPSS increased significantly compared to pre-PCI value (−17.68 vs. −16.65;P < 0.002). 2D-LVEF, on the contrary, did not show any significant increase post-PCI (40.1 vs. 40.57;P = 0.98). Furthermore, the improvement in the average GLPSS was significantly higher when the target vessel revascularized was nonleft anterior descending (LAD) than LAD (−18.32 vs. −17.46;P < 0.001) . Conclusion: The assessment of LV systolic function after PCI in patients with STEMI was superior with GLPSS when compared to 2D LVEF. As strain imaging is an inexpensive tool, it can be applied easily to assess LV function in the large subset of population.