Left ventricular global longitudinal strain following revascularization in acute ST elevation myocardial infarction – A comparison of primary angioplasty and Streptokinase-based pharmacoinvasive strategy

Paul, Amal; George, Paul V

doi:10.1016/j.ihj.2017.04.010

Cited by 7 publications

(10 citation statements)

References 22 publications

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“…This was similar to Paul and George (6) who discovered a substantial difference between individuals treated with primary PCI and those treated with a pharmaco-invasive strategy as regard average GLS which was better in primary PCI group (P=0.03).…”

Section: Discussionsupporting

confidence: 85%

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Primary Angioplasty versus Pharmacoinvasive Strategy in Acute ST-Segment–Elevation Myocardial Infarction

Radwan¹,

Deif²,

Frer³

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: Early reperfusion therapy is necessary for ST-segment elevation myocardial infarction (STEMI), and it can be administered via either a pharmacoinvasive method or primary percutaneous coronary intervention (PPCI). Objective:The aim of the present study was to compare in hospital and 6 months follow up outcome when primary PCI is used to treat individuals with acute STEMI in PPCI capable center or transferred for PPCI when presented to non-PPCI capable center or treated by pharmacoinvasive strategy. Patients and methods: A total of 150 patients with acute STEMI were treated in a row. Each participant was subjected to laboratory investigation, transthoracic echocardiography and coronary angiography (CAG) with PCI was done for all patients. Three groups of patients were created, with 50 patients in Group I receiving treatment with emergency percutaneous coronary intervention in PPCI capable center. Group II included 50 patients were transferred for PPCI when presented to non-PPCI capable center and Group III included 50 patients was treated with pharmaco-invasive strategy when PPCI couldn't be done in a timely fashion. Results: The left ventricle (LV) and right ventricle (RV) function parameters improved following a 6-month follow-up. Across the 3 study groups, there was a very statistically significant difference in terms of average global longitudinal strain (GLS). All the 3 groups of patients showed improvement of LV systolic performance. As regard RV function parameters, it was improved in comparison with in hospital echo parameters with no significant difference as regard RV fractional area change (FAC) and RV S velocity among studied groups. Conclusion: Primary PCI is the strategy of choice for reperfusion of acute STEMI.

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Section: Discussionsupporting

confidence: 85%

“…However, this was discordant with Paul and George (6) who discovered a substantial difference between individuals treated with primary PCI and those treated with a pharmaco-invasive strategy as regard EF which was better in Primary PCI group (P=0.02), this was due to primary PCI group had less risk factors and less extent of CAD.…”

Section: Discussionmentioning

confidence: 63%

Primary Angioplasty versus Pharmacoinvasive Strategy in Acute ST-Segment–Elevation Myocardial Infarction

Radwan¹,

Deif²,

Frer³

et al. 2023

The Egyptian Journal of Hospital Medicine

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“…The utility of GLS has been evaluated in a number of studies enrolling STEMI patients undergoing primary PCI . Besides, LV GLS has been utilized to compare the outcome of primary PCI vs streptokinase‐based pharmaco‐invasive strategy . Studies assessing the impact of extended pharmaco‐invasive therapy on LV function utilizing GLS are sparse.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Besides, LV GLS has been utilized to compare the outcome of primary PCI vs streptokinase-based pharmaco-invasive strategy. 8 trial. 12 The trial showed reduction in infarct size and reduction in 4-year mortality rate in patients with STEMI, who underwent PCI with stenting without symptoms, presenting 12-48 hours after symptom onset.…”

Section: F I G U R E 4 Bull's Eye Chart Of Left Ventricular Global Lomentioning

confidence: 99%

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Observational study of left ventricular global longitudinal strain in ST‐segment elevation myocardial infarction patients with extended pharmaco‐invasive strategy: A six months follow‐up study

et al. 2020

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Aims and Objectives To evaluate left ventricular (LV) function by assessment of LV global longitudinal strain (GLS) in ST‐segment elevation myocardial infarction (STEMI) patients who underwent delayed fibrinolysis and coronary intervention (extended pharmaco‐invasive strategy), since LV function is one of the determinants of both immediate and long‐term outcomes. Methods Prospective study of consecutive STEMI patients who underwent extended pharmaco‐invasive strategy. The LV function was estimated using LV GLS at baseline and at 6 months. Results The study included eighty‐seven STEMI patients who received delayed pharmaco‐invasive therapy and coronary intervention. The primary aim of the study was to evaluate a change in LV function by assessment of GLS at 6 months as compared to baseline. Prior to PCI, LV ejection fraction was 48.08 ± 6.23% and GLS was −11.11 ± 2.99%. Procedural success was achieved in all patients. LV ejection fraction after 6 months of follow‐up increased to 53.12 ± 5.61% and the GLS improved to −13.03 ± 3.06% In comparison to baseline, there was a significant improvement in both LV ejection fraction and GLS at 6 months of follow‐up (P < .001).The cardiac mortality was 1.1% at 6 months. Conclusion There is a significant improvement of LV function as assessed by GLS and ejection fraction at short‐term follow‐up. In a stable cohort of STEMI patients, extended pharmaco‐invasive strategy is also a reasonable option if PCI cannot be performed within the first 24 hours, due to logistic and infrastructural constraints.

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Sonothrombolysis Improves Myocardial Dynamics and Microvascular Obstruction Preventing Left Ventricular Remodeling in Patients With ST Elevation Myocardial Infarction

Aguiar

Tavares

Tsutsui

et al. 2020

Circ: Cardiovascular Imaging

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Background: It has recently been demonstrated that high-energy diagnostic transthoracic ultrasound and intravenous microbubbles dissolve thrombi (sonothrombolysis) and increase angiographic recanalization rates in patients with ST-segment–elevation myocardial infarction. We aimed to study the effect of sonothrombolysis on the myocardial dynamics and infarct size obtained by real-time myocardial perfusion echocardiography and their value in preventing left ventricular remodeling. Methods: One hundred patients with ST-segment–elevation myocardial infarction were randomized to therapy (50 patients treated with sonothrombolysis and percutaneous coronary intervention) or control (50 patients treated with percutaneous coronary intervention only). Left ventricular volumes, ejection fraction, risk area (before treatment), myocardial perfusion defect over time (infarct size), and global longitudinal strain were determined by quantitative real-time myocardial perfusion echocardiography and speckle tracking echocardiography imaging. Results: Risk area was similar in the control and therapy groups (19.2±10.1% versus 20.7±8.9%; P =0.56) before treatment. The therapy group presented a behavior significantly different than control group over time ( P <0.001). The perfusion defect was smaller in the therapy at 48 to 72 hours even in the subgroup of patients with no recanalization at first angiography (12.9±6.5% therapy versus 18.8±9.9% control; P =0.015). The left ventricular global longitudinal strain was higher in the therapy than control immediately after percutaneous coronary intervention (14.1±4.1% versus 12.0±3.3%; P =0.012), and this difference was maintained until 6 months (17.1±3.5% versus 13.6±3.6%; P <0.001). The only predictor of left ventricular remodeling was treatment with sonothrombolysis: the control group was more likely to exhibit left ventricular remodeling with an odds ratio of 2.79 ([95% CI, 0.13–6.86]; P =0.026). Conclusions: Sonothrombolysis reduces microvascular obstruction and improves myocardial dynamics in patients with ST-segment–elevation myocardial infarction and is an independent predictor of left ventricular remodeling over time.

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Left ventricular global longitudinal strain following revascularization in acute ST elevation myocardial infarction – A comparison of primary angioplasty and Streptokinase-based pharmacoinvasive strategy

Cited by 7 publications

References 22 publications

Primary Angioplasty versus Pharmacoinvasive Strategy in Acute ST-Segment–Elevation Myocardial Infarction

Primary Angioplasty versus Pharmacoinvasive Strategy in Acute ST-Segment–Elevation Myocardial Infarction

Observational study of left ventricular global longitudinal strain in ST‐segment elevation myocardial infarction patients with extended pharmaco‐invasive strategy: A six months follow‐up study

Sonothrombolysis Improves Myocardial Dynamics and Microvascular Obstruction Preventing Left Ventricular Remodeling in Patients With ST Elevation Myocardial Infarction

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