The prognostic role of left ventricular global area strain in patients with primary non-ST-elevation myocardial infarction at discharge

Abstract Background Left ventricular(LV) global area strain(GAS) combines the effect of both longitudinal and circumferential shortening. It is derived by 3D speckle tracking echocardiography(STE). LV GAS is an automatic index to assess LV global and regional function. Purpose The aim of this study was to detect the prognostic role of LV GAS in patients with primary non-ST-elevation myocardial infarction(NSTEMI) at discharge. Methods We examined 78 patients(45 males and 33 females, 56±5 years) with primary NSTEMI and without other concomitant cardiovascular diseases. All patients were managed according to guidelines recommendations. Normal LV GAS values are ranged from -27% to -51%, the mean value is around -35%. Transthoracic echocardiography with LV GAS(GE Vivid E95 equipment) was performed at discharge. Study patients were divided into 2 groups: A group(LV GAS≤-25%) and B group(LV GAS-25%). Results The endpoint of the study was rehospitalisation and mortality at 1 year follow up. 31 patients(39.74%) LV GAS-from -18% to -25%(A group), 47 patients (60.26%) LV GAS-from -26% to -45%(B group). The LVEF was from 43-51% in A group, 45-54% in B group(see table 1). One year follow up results have shown that reduced LV GAS was associated with high rehospitalisation and mortality. There were 12 rehospitalisation(38.7%) and 2 deaths(6.4%) in A group(see table 2) and 5 rehospitalisation(10.6%) in B group, p0.03. Conclusion 3D STE derived LV GAS may be considered a strong predictor of rehospitalisation and mortality after primary NSTEMI. Further studies are needed to evaluate the accuracy of the method.Tables LV GAS