Pulse wave velocity to the global longitudinal strain ratio in survivors of myocardial infarction

Abstract

Background: New index of pulse wave velocity to global longitudinal peak systolic strain (PWV/GLPSS) was reported to be associated with cardiovascular damage. We evaluated the prognostic role of this metric in survivors of acute myocardial infarction (AMI). Material and methods: We investigated in 569 patients with AMI, whether PWV/ GLPSS was associated with a composite endpoint of death, stroke or new myocardial infarction, in long-term follow-up. Left ventricular longitudinal strain was evaluated by speckle tracking, and carotid arterial stiffness (local PWV) was determined using radiofrequency data technology. Results: During follow-up (median 1316 days), 114 subjects reached composite endpoint. These subjects were significantly older (P < 0.0001) and were characterized by lower ejection fraction (P < 0.0001), lower GLPSS (P < 0.0001), higher PWV (P = 0.007) and lower PWV/GLPSS index (P < 0.0001). Patients with PWV/ GLPSS <−0.74 were at a significantly higher risk for the composite endpoint during the follow-up (hazard rate: 1.7; 95% confidence interval: 1.2-2.6; P < 0.001). The PWV/GLPSS was additive to the predictive value of EF < 35%-patients with PWV/ GLPSS <−0.74 and EF < 35% had the highest risk for the endpoint events.Conclusions: The current study shows that PWV/GLPSS index has significant, independent and additive value in predicting CV complications, in subjects with myocardial infarction. K E Y W O R D Sglobal longitudinal strain, myocardial infarction, pulse wave velocity