Background: Left ventricular ejection fraction (LVEF) is fundamental for risk stratification
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
Objectives: We hypothesized that semiautomated calculation of baseline global longitudinal
strain (GLS) can identify high-risk
group among patients with LVEF ≥ 50%
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
(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%
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.