Prognostic power of global 2D strain according to left ventricular ejection fraction in patients with ST elevation myocardial infarction

Abstract

BackgroundsWe aimed to evaluate the predictive power of longitudinal and circumferential fibers according to left ventricular ejection fraction (LVEF) in successfully reperfused acute ST elevation myocardial infarction (STEMI) patients.MethodsTotal 691 patients (age 59±13, 20% female) underwent clinical evaluation and conventional and strain echocardiography (Global longitudinal strain (GLS), global circumferential strain (GCS)). The clinical outcome was defined as the composite of death, hospitalization for heart failure, non-fatal myocardial infarction, and ventricular arrhythmia.ResultsDuring a follow-up of 39±19 months, there were 47 (6.8%) clinical events. In multivariate Cox models adjusted clinical risk factors, age (HR 1.08, p = 0.001) and GLS (HR 1.37, p = 0.001) were independent predictors. The addition of GLS resulted in significant incremental improvement in the predictive value on LVEF (χ2 = 31.8→45.8, p<0.001), although GCS offers no additional benefit. In the subgroup analysis according to LVEF, adjusted with clinical factors, GLS was significant predictive for outcome for the patients with mildly depressed (LVEF 40–50%, HR 2.25, p<0.001) and significantly depressed (LVEF<40%, HR 1.28, p = 0.016) systolic function, although GCS and LVEF lost their power with LVEF<40%. For the patients with preserved LVEF (>50%), GLS, GCS and LVEF did not show significant predictive power.ConclusionsGLS is a most powerful predictor of outcome in successfully reperfused STEMI patients, especially with depressed LV dysfunction, although GCS and LVEF lost their predictive power for the patients with significantly depressed LV function. However, GLS did not predict outcome for the patients with preserved LVEF (>50%).

Longitudinal wall fractional shortening: an M-mode index based on mitral annular plane systolic excursion (MAPSE) that correlates and predicts left ventricular longitudinal strain (LVLS) in intensive care patients

“…For example, strain was able to identify impaired ventricular function in patients with early septic shock but preserved ejection fractions [ 3 ]. GLS can also be used for predicting outcomes in patients with heart failure and myocardial infarction [ 4 , 5 ]. However, transthoracic echocardiographic (TTE) images are often suboptimal for strain measurement in the critically ill patients.…”

Speckle Tracking Stress Echocardiography on Treadmill in Assessment of the Functional Significance of the Degree of Coronary Artery Disease

“…У больных ИБС глобальная продольная систолическая деформация (ГПСД) ЛЖ имеет диагностическое и прогностическое значение [5][6][7]. Наряду с этим в отдельных исследованиях продемонстрировано, что ГПСД ЛЖ может быть ОРИГИНАЛЬНЫЕ СТАТЬИ § использована для оценки функциональной значимости степени стеноза коронарных артерий (КА) при спекл-трекинг стресс-ЭхоКГ [8][9][10][11][12].…”

Cвязь Маркеров Повреждения Миокарда И Показателей Кислородного Бюджета С Параметрами Гемодинамики У Пациентов С Недостаточностью Митрального Клапана

“…Один из критериев гемодинамики -сократительная способность миокарда [5]. В последнее время с целью количественной оценки глобальной и сегментарной сократимости миокарда все чаще используют спекл-трекинг эхокардиографию [6,7], ключевым количественным показателем которой является деформация миокарда. Ее измеряют в процентах как изменение длины сегмента в систолу по сравнению с исходным состоянием в конце диастолы [8,9].…”