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Left ventricular torsion assessed by two‐dimensional echocardiography speckle tracking as a predictor of left ventricular remodeling and short‐term outcome following primary percutaneous coronary intervention for acute myocardial infarction: A single‐center experience
Author(s) -
Awadalla Hany,
Saleh Mohamed Ayman,
Abdel Kader Mohamed,
Mansour Amr
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13611
Subject(s) - cardiology , medicine , percutaneous coronary intervention , myocardial infarction , speckle tracking echocardiography , ventricular remodeling , torsion (gastropod) , percutaneous , heart failure , surgery , ejection fraction
Aims Left ventricular ( LV ) torsion is a novel method to assess systolic LV function. This study aimed at exploring the utility of 2D speckle tracking–based assessment of left ventricular torsion in patients with acute myocardial infarction ( AMI ) undertaking primary percutaneous intervention ( pPCI ) in predicting left ventricular remodeling. Methods and Results The study included 115 patients (mean± SD , age 52.2±9.67, males 84.3%) who underwent pPCI for AMI . Echocardiographic assessment of LV torsion by two‐dimensional speckle tracking was performed early after the index pPCI . Patients underwent repeat echocardiography at 6 months to detect remodeling. LV torsion in the acute setting was significantly lower in those who demonstrated LV remodeling at follow‐up compared to those without remodeling (7.56±1.95 vs 15.16±4.65; P <.005). Multivariate analysis identified peak CK & CK ‐ MB elevation (β=−0.767 and −0.725; P <.001), SWMA index (β=−0.843; P <.001), and Simpson's derived LV ejection fraction ( LVEF ; β=0.802; P <.001) as independent predictors of baseline LV torsion. It also identified peak LV torsion (β: 0.27; 95% CI : 0.15–0.5, P =.001) and SWMA index (β: 1.07, 95% CI : 1.03–1.12, P =.005) as independent predictors of LV remodeling. Baseline Killip's grades II and higher (β: 48.6; 95% CI 5.5–428, P <.001) and diabetes mellitus (β: 29.7; 95% CI 1.1–763, P <.05) were independent predictors of mortality. Conclusion Left ventricular torsion in acute MI setting is impaired and predicts subsequent LV remodeling at 6‐month follow‐up.