Left ventricular strain: A reliable predictor of short-term outcomes in patients with anterior wall myocardial infarction without heart failure

Abstract

Background: Left ventricular ejection fraction (LVEF) is a key determinant in decision-making after acute myocardial infarction (MI). Little is known of its relationship with left ventricular Strain and N-Terminal fragment of pro-B-type Natriuretic Peptide (NT-pro-BNP) following acute anterior wall MI (AWMI). Materials and Methods: We conducted a prospective cohort study of patients with a diagnosis of acute AWMI and the absence of overt heart failure (HF). Assessment of LVEF, strain parameters on echocardiography was done, and NT-pro-BNP levels were obtained. Follow-up for adverse cardiac events was done for 30 days postdischarge. Correlation of LVEF and NT-pro-BNP with various strain parameters were ascertained. Results: Of the total of 50 patients of AWMI enrolled, the mean LVEF in the study was 43.46 ± 3.72%.Eleven patients (22%) had adverse events at 30 days of follow-up. Patients with adverse events had significantly higher overall peak systolic longitudinal strain (PSLS), lower mid-region peak systolic longitudinal velocity (PSLV), and basal region PSLV. A significant negative correlation was observed between LVEF and mean Peak PSLS of combined apical plus mid regions of the left ventricle ( r = −0.700). Log10-NT-pro BNP also showed a strong negative correlation with overall PSLV ( r = −0.792) as well as regional PSLV values of combined apical plus mid ( r = −0.763) and basal segments ( r = −0.748). Conclusions: In patients with AWMI without HF, PSLS and PSLV are good predictors of adverse outcomes at 30-day follow-up. Furthermore, NT-pro BNP can also be an indirect predictor of strain parameters on echocardiography.

Longitudinal Assessment of Left Ventricle Systolic Function in Acute Myocardial Infarction Patients Post Percutaneous Coronary Intervention

“…The current study found that LV strain was not able to predict major adverse cardiovascular events (MACE) at one-month follow-up, but when comparing 2 groups in the presence and absence of events, for the clinical and echocardiographic variables exhibits substantial differences. LV Strain was found to be signi cantly lower in patients with MACE than event free group .Hence GLS was proved to have higher sensitivity in detecting subclinical LV dysfunction when compared to LVEF4.In contrary, studies proved that apart from NT-pro BNP and LVEF, PSLV's and PSLS are good predictors of adverse outcomes at 30 day follow up 9 .…”

Recovery and prognostic values of myocardial strain in acute anterior and non-anterior wall myocardial infarction

“…Myocardial strain can be used to assess both global systolic function and systolic and diastolic function. Strain has substantial potential to be of diagnostic and prognostic value, and most of the clinical evidence for strain measurement is obtained by echocardiography [11]. However, inadequate image quality and considerable observer variability are well-known limitations of echocardiographic techniques and affect myocardial strain measurement reliability [4].…”