Impact of global longitudinal strain on left ventricular remodeling and clinical outcome in patients with ST‐segment elevation myocardial infarction (STEMI)

Abstract

Background: Predicting left ventricle (LV) remodeling is important for outcome prediction in patients with ST-segment elevation myocardial infarction (STEMI). Novel echocardiographic techniques may be beneficial for those patients. Objectives:We hypothesized that the semiautomated calculation of baseline global longitudinal strain (GLS) can predict LV remodeling and 6-month clinical outcomes in these patients. Methods:During the period from March to December 2018, 130 patients with successful reperfusion of STEMI were prospectively included. Within 48 hours, patients underwent a baseline GLS study with follow-up study at 6 months. Patients were divided into two groups: group I: patients who showed adverse LV remodeling and group II: patients who did not. The endpoint was a composite of cardiovascular mortality, readmission due to heart failure, and urgent revascularization. Results:The mean baseline GLS changed from −13.1 ± 3.5% for group I and −16.8 ± 3.1% for group II, to −10.2 ± 4.7% and −12.6 ± 3.1%, respectively, at 6-month follow-up. ROC analysis demonstrated a cutoff value of baseline GLS > −12.5% predicted LV remodeling with 64.5% sensitivity and 89% specificity (AUC 0.797, 95% CI 0.690-0.904). Multivariate logistic regression analysis model using 6-month MACEs occurrence as a dependent factor showed baseline GLS value> −12.5% to be the only significant independent predictor MACEs occurrence (OR 0.704, 95% CI 0.597-0.829, P < .001). Linear regression analysis showed that for every point estimate deterioration of baseline GLS, there was a significant corresponding 2.55 mL increase in LVEDV at 6-month follow-up (CI −4.501 to −0.612, P = .01).Conclusion: GLS measurement can predict remodeling and adverse clinical events in STEMI patients.

Incremental prognostic value of speckle tracking echocardiography and early follow‐up echo assessment in predicting left ventricular recovery after reperfusion for ST‐segment elevation myocardial infarction (STEMI)

“…41 .010* CI, confidence interval; GCS, global circumferential strain; GLS, global longitudinal strain; LL, lower limit; OR, odds ratio; UL, upper limit * Denote signficant P values have shown that GLS can provide valuable information on myocardial viability and predict functional recovery after MI. 16,42 In our study, Univariate analysis showed both GLS at baseline and follow-up significant associates of LVEF recovery . However, multivariate analysis including both, showed only follow-up GLS at 6 weeks to be a strong independent predictor for LV recovery (OR = 1.417, 95% CI (1.101-1.824, p = .007).…”

“…Several studies have identified baseline GLS assessed acutely after PPCI as a predictor of LVEF recovery and adverse remodeling 15,16 . However, limited data exists on the predictive value of follow‐up GLS and other strain parameters such as GCS.…”

“…[12][13][14] Several studies have identified baseline GLS assessed acutely after PPCI as a predictor of LVEF recovery and adverse remodeling. 15,16 However, limited data exists on the predictive value of follow-up GLS and other strain parameters such as GCS. Furthermore, diastolic dysfunction assessed by E/e' ratio obtained from tissue Doppler imaging (TDI) has been shown to predict LV remodeling after STEMI.…”

Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry

“…In fact, GLS has already been shown to be a predictor of LVRR at long‐term follow‐up in different cohorts of patients, for example, with dilated cardiomyopathy or acute myocardial infarction. 33 , 34 , 35 …”

“…Therefore, patients with worse baseline GLS would have higher degrees of intrinsic myocardial damage, which results in being irreversible with pharmacological therapy; on the contrary, patients with less impaired LV strain would have lower grades of damage resulting in more chances of recovery. In fact, GLS has already been shown to be a predictor of LVRR at long‐term follow‐up in different cohorts of patients, for example, with dilated cardiomyopathy or acute myocardial infarction 33–35 …”