ISSN: 1859 - 2872
Predictive value of myocardial strain for major adverse cardiac events and mortality in patients with acute ST elevation myocardial infarction after primary percutaneous coronary intervention
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Abstract
Objective: To study the predictive value of left ventricular global longitudinal strain (GLS) for major adverse cardiac events (MACE) and mortality in patients with acute ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention. Subject and method: 118 STEMI patients after primary percutaneous coronary intervention (PCI) hospitalized in Vietnam National Heart Institute from January 2016 to March 2019 were included. Two dimentional (2D) speckle tracking echocardiography was done for all patients within 24 hours after primary PCI. Echocardiography images were analyzed to assess GLS by EchoPAC 112 software (GE, USA). All patients were followed-up for 6 months for major adverse cardiac events (MACE) including all-cause death, heart failure hospitalization, re-infarction and stroke. Result: Mean age: 64.73 ± 11.88 years. Male: 81.4%, Killip > I was 24.6%. There were 26 patients (22%) who got MACE within first 6 months. By analyzing the ROC curve, GLS could predict MACE with AUC = 0.95 (95%CI: 0.91–0.99). The cut-off point GLS ≥ -9.5% predicted MACE with sensitivity = 84.6% and specificity = 94.6%. In multivariates Cox model, NT-proBNP with HR = 1.78 (95%CI: 1.01-3.15), p<0.05 and GLS with HR = 1.53 (95%CI: 1.14-2.04), p<0.001 were independent predictors. GLS could predict mortality with AUC = 0.96 (95%CI: 0.92-0.99). The cut-off point GLS ≥ -8.4% predicted mortality with sensitivity = 84.6% and specificity = 94.6%. In multivariates Cox model, GLS was independent predictor with HR = 1.53 (95%CI: 1.14-2.04), p<0.001. Conclusion: GLS by 2D speckle tracking echocardiography strongly and independently predicted MACE and mortality in patients with STEMI after primary PCI within first 6 months.
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2. Park YH, Kang SJ, Song JK et al (2008) Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction. J Am Soc Echocardiogr 21: 262-267.
3. Bochenek T, Wita K, Tabor Z et al (2011) Value of speckle-tracking echocardiography for prediction of left ventricular remodeling in patients with ST-elevation myocardial infarction treated by primary percutaneous intervention. J Am Soc Echocardiogr 24(12): 1342-1348.
4. Thygesen K, Alpert JS, Jaffe AS et al (2012) Third universal definition of myocardial infarction. Circulation 126(16): 2020-2035.
5. Patel MR, Calhoon JH, Dehmer GJ et al (2017) ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 appropriate use criteria for coronary revascularization in patients with acute coronary syndromes. Journal of the American College of Cardiology 69(5): 570-591.
6. Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1): 1-39.
7. Iwahashi N, Kirigaya J, Gohbara M et al (2022) Mechanical dispersion combined with global longitudinal strain estimated by three dimensional speckle tracking in patients with ST elevation myocardial infarction. IJC Heart & Vasculature 40(2022): 101028.
8. Cha MJ, Kim HS, Park JH et al (2017) Prognostic power of global 2D strain according to left ventricular ejection fraction in patients with ST elevation myocardial infarction. PLoS One 12(3): e0174160.
9. Lacalzada-Almeida J, de la Rosa A, Izquierdo M et al (2015) Left ventricular global longitudinal systolic strain predicts adverse remodeling and subsequent cardiac events in patients with acute myocardial infarction treated with primary percutaneous coronary intervention. The international journal of cardiovascular imaging 31.
10. Antoni ML, Mollema SA, Delgado V et al (2010) Prognostic importance of strain and strain rate after acute myocardial infarction. Eur Heart J 1(13): 1640-1647.
11. Kanar BG, Tigen MK, Sunbul M et al (2018) The impact of right ventricular function assessed by 2-dimensional speckle tracking echocardiography on early mortality in patients with inferior myocardial infarction. Clinical Cardiology 41(3): 413-418.
12. Abou R, Goedemans L, van der Bijl P et al (2020) Correlates and Long-Term Implications of Left Ventricular Mechanical Dispersion by Two-Dimensional Speckle-Tracking Echocardiography in Patients with ST-Segment Elevation Myocardial Infarction. J Am Soc Echocardiogr 33(8): 964-972.
13. Kalam K, Otahal P, Marwick TH (2014) Prognostic implications of global LV dysfunction: A systematic review and meta-analysis of global longitudinal strain and ejection fraction. Heart 100(21): 1673-1680.
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