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Prof. Mohamed Abdou Mohamed Salem :: Publications:

Title:
Impact of global longitudinal strain on left ventricular remodeling and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI)
Authors: Wael Tawfik MD | Amr El-Sherif MSc | Ahmed Bendary MD | Mohammed Mahros MD | Mohamed Salem MD, PhD
Year: 2020
Keywords: 6-month outcome, GLS, remodeling, STEMI
Journal: Echocardiography
Volume: 37
Issue: Not Available
Pages: 570
Publisher: Wiley Periodicals, Inc.
Local/International: International
Paper Link: Not Available
Full paper Mohamed Abdou Mohamed Salem_Echo.pdf
Supplementary materials Not Available
Abstract:

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.

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