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The predictive value of global longitudinal strain on clinical outcome in patients with ST‐segment elevation myocardial infarction and preserved systolic function
Author(s) -
Bendary Ahmed,
Tawfeek Wael,
Mahros Mohammed,
Salem Mohamed
Publication year - 2018
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.13866
Subject(s) - ejection fraction , medicine , cardiology , mace , myocardial infarction , revascularization , heart failure , predictive value of tests , conventional pci
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 MACE s 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 MACE s ( 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 .