Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients With ST-Segment Elevation Myocardial Infarction

Highlights•At baseline after STEMI, LVEF and LVGLS are on average preserved or mildly reduced.•At 1 year after STEMI LV systolic function has improved in most patients.•A >7% relative decrease in LVGLS is linked to 2.5 times higher all-cause mortality.AbstractIntroductionAfter ST-segment elevation myocardial infarction (STEMI), follow-up imaging is currently recommended only in patients with left ventricular ejection fraction (LVEF) 7%. Cumulative 10-year survival was 91% in patients with ΔGLS improvement or a nonsignificant decrease, versus 85% in patients with ΔGLS decrease of >7% (P = .001). On multivariate Cox regression analysis, ΔGLS decrease >7% remained independently associated with the end point (hazard ratio, 2.5 95% CI, 1.5–4.1; P < .001) after adjustment for clinical and echocardiographic parameters.ConclusionsA significant decrease in LVGLS 1 year after STEMI was independently associated with long-term all-cause mortality and might help further risk stratification and management of these patients during follow-up.Graphical abstractPrognostic value of change in LVGLS after STEMI.Central Illustration