Prognostic Value of Speckle Tracking Echocardiography in Patients with <scp>ST</scp>‐Elevation Myocardial Infarction Treated with Late Percutaneous Intervention

Cong, Tao; Sun, Yong; Shang, Zhijuan; Wang, Ke; Su, Dechun; Zhong, Lei; Zhang, Shulong; Yang, Yanzong

doi:10.1111/echo.12864

Cited by 29 publications

(23 citation statements)

References 28 publications

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“…The use of GLS most consistently detected the change in LV volume during follow-up among the different studies [14–16, 24, 25, 30–34, 36,37]. The determinant cut-off value of GLS for adverse remodeling ranged from -12.8% to -10.2% and from -13.7% to -9.5% for reverse modeling.…”

Section: Resultsmentioning

confidence: 89%

“…In addition, multivariable ORs were available in 4 studies, 2 of which stemmed from the same studies with available univariable OR [15–17, 38]. To account for this heterogeneity, we constructed a random-effects model, which provided a very similar association (pooled OR = 1.38, 1.13–1.70, p = 0.002) as that reported for the univariable OR (Fig 2).…”

Section: Resultsmentioning

confidence: 93%

“…There were 11 studies assessing adverse remodeling [14–24], 11 assessing reverse remodeling [25–35] and 1 assessing both outcomes [36]. All patients reported in these studies had a successfully revascularized first STEMI (as defined by TIMI flow>2) except for 2 studies in which both STEMI and NTEMI patients were included [19,36]; only 2 studies included medical revascularization with thrombolysis.…”

Section: Resultsmentioning

confidence: 99%

“…The first assessment is usually performed at discharge by Simpson biplane 2D LVEF on transthoracic echocardiography (TTE). In several studies, the first TTE was performed within the first 24h [24, 28, 34], most of the time within the first 48h and never after day 10. This differential timing of assessment may lead to an over- or under-estimation of remodeling due to rapid dynamic changes occurring during the first week.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of Left Ventricular Remodeling after a Myocardial Infarction: Role of Myocardial Deformation: A Systematic Review and Meta-Analysis

Huttin

Coiro²,

Selton‐Suty

et al. 2016

PLoS ONE

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AimsLeft ventricular (LV) adverse or reverse remodeling after ST-segment elevation myocardial infarction (MI) is the best outcome to assess the benefit of revascularization. Speckle tracking echocardiography (STE) may accurately identify early deformation impairment, while also being predictive of LV remodeling during follow-up. This systematic analysis aimed to provide a comprehensive review of current findings on STE as a predictor of LV remodeling after MI.MethodsPubMed databases were searched through December 2014 to identify studies in adults targeting the association between LV remodeling and STE. Meta-regression was performed for longitudinal analysis.ResultsA total of 23 prospective studies (3066 patients) were found eligible. Eleven studies reported an association between STE and adverse remodeling and twelve studies with reverse remodeling. Using peak systolic longitudinal strain, the most accurate cut-off to predict adverse remodeling and reverse remodeling ranged from -12.8% to -10.2% and from -13.7% to -9.5%, respectively. In smaller studies, assessment of circumferential strain and torsion showed additive value in predicting remodeling. Meta-regression analysis revealed that longitudinal STE was associated with adverse remodeling (pooled univariable OR = 1.27, 1.17–1.38, p<0.001; pooled multivariable OR = 1.38, 1.13–1.70, p = 0.002) while pooled ORs of longitudinal STE only tended to predict reverse remodeling (pooled OR = 0.75, 0.54–1.06, p = 0.09).ConclusionsThis systematic review suggests that STE is associated with changes in LV volume or function regardless of underlying mechanisms and deformation direction. Meta-regression demonstrates a strong association between peak longitudinal systolic strain and adverse remodeling. Added STE predictive value over other clinical, biological and imaging variables remains to be proven.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prediction of Left Ventricular Remodeling after a Myocardial Infarction: Role of Myocardial Deformation: A Systematic Review and Meta-Analysis

Huttin

Coiro²,

Selton‐Suty

et al. 2016

PLoS ONE

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“…Speckle tracking echocardiography (STE) is advantageous compared to conventional echocardiographic determinants of LV systolic function (EF, wall‐motion score) as is not influenced by tethering of adjacent myocardial segments, ultrasound beam alignment, and allows assessment of cardiac mechanics in all spatial planes: longitudinal, circumferential, and radial . Understanding alterations of myocardial contractility in various myocardial disorders may have important clinical and prognostic implications . Functional ischemic mitral regurgitation in inferoposterior myocardial infarction is predominately predisposed by impaired regional LV contractility resulting in tethering and systolic restriction of posterior mitral valve leaflet, thus impeding mitral valve closure .…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Mechanics in Functional Ischemic Mitral Regurgitation in Acute Inferoposterior Myocardial Infarction

et al. 2016

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Ischemic mitral regurgitation (MR) is an established adverse prognostic factor after myocardial infarction (MI). Functional ischemic mitral regurgitation in acute phase of MI remains under‐investigated due to its often transient and dynamic nature. We aimed to assess left ventricular (LV) mechanics by speckle‐tracking echocardiography in acute inferoposterior MI and ischemic mitral regurgitation (MR).MethodsSixty‐nine patients with no structural cardiac valve abnormalities and first acute inferoposterior MI were prospectively enrolled into the study. Two‐dimensional transthoracic echocardiography for regional myocardial function and valve assessment was performed within 48 hours of presentation after reperfusion therapy (percutaneous coronary intervention). Based on degree of MR, patients were divided into no significant MR (NMR) group (N = 34, with no or mild (grade 0–I) MR) and ischemic MR (IMR) group (N = 35, with grade ≥2 MR). Thirty‐five age‐ and gender‐matched healthy individuals served as a normal reference group. Offline 2D speckle tracking analysis was performed with GE EchoPAC software.ResultsLV ejection fraction and longitudinal myocardial deformation parameters were significantly better in healthy subjects, but did not differ between both study groups. All circumferential myocardial deformation parameters were significantly worse in IMR group compared to healthy subjects and NMR group. Global, basal, and mid‐ventricular radial strain was significantly lower in IMR group compared to both—healthy subjects and NMR group.ConclusionIschemic mitral regurgitation in acute inferoposterior MI is associated with worse radial and circumferential LV deformation parameters assessed by 2D speckle tracking echocardiography.

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Effects of late, repetitive remote ischaemic conditioning on myocardial strain in patients with acute myocardial infarction

et al. 2022

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Late, repetitive or chronic remote ischaemic conditioning (CRIC) is a potential cardioprotective strategy against adverse remodelling following ST-segment elevation myocardial infarction (STEMI). In the randomised Daily Remote Ischaemic Conditioning Following Acute Myocardial Infarction (DREAM) trial, CRIC following primary percutaneous coronary intervention (P-PCI) did not improve global left ventricular (LV) systolic function. A post-hoc analysis was performed to determine whether CRIC improved regional strain. All 73 patients completing the original trial were studied (38 receiving 4 weeks’ daily CRIC, 35 controls receiving sham conditioning). Patients underwent cardiovascular magnetic resonance at baseline (5–7 days post-STEMI) and after 4 months, with assessment of LV systolic function, infarct size and strain (longitudinal/circumferential, in infarct-related and remote territories). At both timepoints, there were no significant between-group differences in global indices (LV ejection fraction, infarct size, longitudinal/circumferential strain). However, regional analysis revealed a significant improvement in longitudinal strain in the infarcted segments of the CRIC group (from − 16.2 ± 5.2 at baseline to − 18.7 ± 6.3 at follow up, p = 0.0006) but not in corresponding segments of the control group (from − 15.5 ± 4.0 to − 15.2 ± 4.7, p = 0.81; for change: − 2.5 ± 3.6 versus + 0.3 ± 5.6, respectively, p = 0.027). In remote territories, there was a lower increment in subendocardial circumferential strain in the CRIC group than in controls (− 1.2 ± 4.4 versus − 2.5 ± 4.0, p = 0.038). In summary, CRIC following P-PCI for STEMI is associated with improved longitudinal strain in infarct-related segments, and an attenuated increase in circumferential strain in remote segments. Further work is needed to establish whether these changes may translate into a reduced incidence of adverse remodelling and clinical events. Clinical Trial Registration: http://clinicaltrials.gov/show/NCT01664611.

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Prognostic Value of Speckle Tracking Echocardiography in Patients with ST‐Elevation Myocardial Infarction Treated with Late Percutaneous Intervention

Abstract: In patients with STEMI treated with late percutaneous coronary intervention, the GLS as measured by STE is a strong predictor of LVr and adverse events.

Cited by 29 publications

References 28 publications

Prediction of Left Ventricular Remodeling after a Myocardial Infarction: Role of Myocardial Deformation: A Systematic Review and Meta-Analysis

Prediction of Left Ventricular Remodeling after a Myocardial Infarction: Role of Myocardial Deformation: A Systematic Review and Meta-Analysis

Left Ventricular Mechanics in Functional Ischemic Mitral Regurgitation in Acute Inferoposterior Myocardial Infarction

Effects of late, repetitive remote ischaemic conditioning on myocardial strain in patients with acute myocardial infarction

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