Background: Left ventricular ejection fraction (LVEF) is fundamental for risk stratification
after ST-segment
elevation myocardial infarction (STEMI). However, it lacks
discrimination power within normal range. Novel echocardiographic deformation parameters
may be of benefit for those with post-MI
preserved LVEF.
Objectives: We hypothesized that semiautomated calculation of baseline global longitudinal
strain (GLS) can identify high-risk
group among patients with LVEF ≥ 50%
following STEMI.
Methods: During the period from January to July 2017, 110 patients with successful
reperfusion of STEMI and LVEF ≥ 50% were prospectively included. Within 48 hours,
patients underwent a baseline GLS study with follow-up
study at 30 days. The endpoint
was a composite of cardiovascular mortality, rehospitalization for heart failure,
and urgent revascularization.
Results: Mean GLS value changed from −16 ± 4% at baseline to −12 ± 4% at 30-day
follow-up
(P < .001). At 30 days, cardiovascular mortality was reported in 4.5%,
11.8% were rehospitalized due to heart failure, and 5.4% underwent urgent revascularization.
ROC curve analysis showed that a cutoff baseline GLS value >−12.65%
predicted 30-day
MACEs with a sensitivity and specificity of 77.8% and 83.7%, respectively
(AUC 0.784, 95% CI 0.646–0.921, P < .001). An adjusted multivariate logistic
regression analysis revealed that baseline GLS value >−12.65% to be the only
significant independent predictor for occurrence of MACEs (OR 19.54, 95% CI 6.3–
61.1, P < .001).
Conclusion: Early GLS calculation predicts 30-day
outcome in patients with preserved
LVEF following reperfusion of STEMI.
K E Y W O R D S
2D echocardiography, myocardial infarction, myocardial strain |
