Left ventricular global longitudinal systolic strain predicts adverse remodeling and subsequent cardiac events in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Abstract

To determine whether left ventricular (LV) global longitudinal strain (GLS) predicts adverse LV remodeling and cardiac events. In a prospective cohort study of patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI), we recorded clinical data and GLS, global circumferential strain and radial strain using two-dimensional speckle-tracking echocardiography of the left ventricle. At 6-month and 3-year follow-ups, patients were grouped by presence or absence of adverse LV remodeling. We used logistic regression to identify factors associated with adverse LV remodeling and a Cox model to determine the relationships between these factors and cardiac events. Of 97 patients (mean age 56 ± 12 years; 76 men), 38 showed LV remodeling. Diabetes mellitus [odds ratio (OR) 1.95% confidence interval (CI) 1.2-4.8, p = 0.05], peak troponin I (OR 1.2, 95% CI 1.1-1.3, p = 0.004), and GLS (OR 1.6, 95% CI 1.3-2.3, p = 0.009) independently predicted LV remodeling. During follow-up (22.8 ± 12.3 months), 20 patients suffered adverse events, which were independently predicted by GLS alone (OR 4.9, 95% CI 1.7-13.9, p = 0.002). Optimal GLS cutoffs for predicting adverse LV remodeling and cardiac events were >-12.46% [area under receiver operating-characteristic curve (AUC) 0.88, 95% CI 0.79-0.96, p < 0.001] and >-9.27% (AUC 0.86, 95% CI 0.64-0.98, p < 0.001), respectively. GLS measured immediately after primary PCI is an excellent predictor of adverse LV remodeling and cardiac events in patients with AMI.

Two-Dimensional Speckle Tracking Echocardiography Predict Left Ventricular Remodeling after Acute Myocardial Infarction in Patients with Preserved Ejection Fraction

“…In our study, LV remodeling was found in 28.4% of the cohort, and this occurrence rate is comparable to but lower than the rates reported in previous studies [1–4,12,14,16,22]. EF has been associated with LV remodeling [10,12,13].…”

“…Fifty patients with anterior-wall AMI were enrolled, and 22 patients developed LV remodeling. Previous studies discovered the value of GLS for predicting LV remodeling in STEMI or NSTEMI [11–13,16]. Bochenek et al evaluated 66 patients with ST–T elevation myocardial infarction treated by primary PCI [11].…”

Longitudinal strain combined with delayed-enhancement magnetic resonance improves risk stratification in patients with dilated cardiomyopathy

“…Cho et al 31 also allowed the lower reproducibility of GCS in their article. Several other studies support the superiority of GLS to GCS and GRS as an indicator of adverse events or LV dysfunction 32 33…”

Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI

“…Several studies have determined that 2D speckle-tracking derived LV strain parameters provides valuable prediction of subsequent cardiac events and outcome in patients with AMI who have been treated by primary PCI [25,26]. However, data about the early prognostic value of LV strain parameter is lacking.…”

“…Previous studies have demonstrated the long-term prognostic relevance of strain echocardiography after AMI [21][22][23][24][25][26][27][28][29]. However, the short-term prognostic value of strain echocardiography in patients with STEMI has not been well evaluated.…”