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Background: Impairment of left ventricular systolic function after ST elevation myocardial infarction (STEMI) is major complication and associated with long term poor outcome. Purpose: In this study, we proposed to check whether early RAAS inhibition is associated with improved LV function in patients with STEMI. Methods: In this study, we prospectively included patients with STEMI who were treated by primary percutaneous coronary intervention (PCI). We choose left ventricular (LV) global longitudinal strain (GLS) as a marker of LV systolic function. GLS was estimated by using a two dimensional (2D) speckle-tracking echocardiography (STE). Results: A total of 473 patients (59±13, 86% male) were selected for this study. In patients without previous hypertension, LV GLS was significantly different between patients who received treatment with RAAS inhibition (ACEi or ARB) during their admission and patients who didn’t (-16.2% vs. -14.9%, p<0.05). In patients with previous hypertension, however, LV GLS was similar between patients who received treatment with RAAS inhibition during their admission and patients who didn’t (-14.9% vs. -14.8%, p=0.881). Multiple linear regression analysis which including age, gender, DM, CKD, previous CAD, previous MI, previous CHF, showed that treatment with RAAS inhibition was independent predictor of improved GLS in patients without previous hypertension (β=1.23, 95% CI 0.21–2.20, r=0.158, r2=0.025, p<0.05).

european heart journal

P3365Early inhibition of renin-aniotensin-aldosterone system is associated with improved left ventricular function in STEMI survivors without previous hypertension: a two dimensional speckle-tracking study