Background: Predicting left ventricle (LV) remodeling is important for outcome prediction
in patients with ST-segment elevation myocardial infarction (STEMI). Novel
echocardiographic techniques may be beneficial for those patients.
Objectives: We hypothesized that the semiautomated calculation of baseline global
longitudinal strain (GLS) can predict LV remodeling and 6-month clinical outcomes in
these patients.
Methods: During the period from March to December 2018, 130 patients with successful
reperfusion of STEMI were prospectively included. Within 48 hours, patients
underwent a baseline GLS study with follow-up study at 6 months. Patients were
divided into two groups: group I: patients who showed adverse LV remodeling and
group II: patients who did not. The endpoint was a composite of cardiovascular mortality,
readmission due to heart failure, and urgent revascularization.
Results: The mean baseline GLS changed from −13.1 ± 3.5% for group I and
−16.8 ± 3.1% for group II, to −10.2 ± 4.7% and −12.6 ± 3.1%, respectively, at 6-month
follow-up. ROC analysis demonstrated a cutoff value of baseline GLS > −12.5% predicted
LV remodeling with 64.5% sensitivity and 89% specificity (AUC 0.797, 95% CI
0.690-0.904). Multivariate logistic regression analysis model using 6-month MACEs
occurrence as a dependent factor showed baseline GLS value> −12.5% to be the
only significant independent predictor MACEs occurrence (OR 0.704, 95% CI 0.597-
0.829, P < .001). Linear regression analysis showed that for every point estimate deterioration
of baseline GLS, there was a significant corresponding 2.55 mL increase
in LVEDV at 6-month follow-up (CI −4.501 to −0.612, P = .01).
Conclusion: GLS measurement can predict remodeling and adverse clinical events in
STEMI patients. |
