Average peak systolic global longitudinal strain > -12.5% (OR 1.7) and LV torsion < 9.5° (OR 1.5) early after myocardial infarction independently predicted left ventricular remodeling at 6 months.
Cohort (n=85)
No
Does speckle tracking echocardiography (GLS and LV torsion) predict left ventricular remodeling at 6 months in patients with first anterior STEMI managed by primary PCI?
Early assessment of global longitudinal strain and LV torsion using speckle tracking echocardiography can independently predict adverse left ventricular remodeling 6 months after an anterior STEMI.
Estimación del efecto: OR 1.7 (95% CI 0.4-13.8)
valor p: p=0.04
Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. LV remodeling is an important factor in the pathophysiology of advancing heart failure (HF). To evaluate the value of speckle tracking imaging as a predictor of left ventricular remodeling 6 months after first anterior STEMI in patients managed by primary PCI. Eighty-five patients with first acute anterior STEMI underwent primary PCI. Patients were followed up for 6 months. Echocardiography was done within 48 h 1 Standard transthoracic 2D echocardiographic examination: LV internal dimensions and volumes, Left Ventricular EF, and Wall Motion Score Index: 2 LV peak systolic global longitudinal strain and Torsion dynamics were assessed. Echocardiography was repeated at 6 months LV volumes and EF were calculated. LV remodeling was defined as an increase in LV EDV ≥ 20% 6 months after infarction as compared to baseline data. Patients were then classified into Group I: did not develop LV remodeling. Group II: developed LV remodeling. Both groups were studied to determine predictors of LV remodeling. At baseline echocardiographic evaluation there was no statistically significant difference between both groups regarding both LVEDD and LVEDV, while there was statistically significant increase in both LV ESD and LV ESV, with statistically significant lower Ejection Fraction, in LV remodeling group. There was also statistically significant higher LV peak systolic GLS values in LV remodeling group, the best cut-off value was >−12.5 (Sensitivity 87%, Specificity 85%) and LV torsion was also statistically significantly lower in the LV remodeling group, with the best cut-off value for LV torsion was 1.8, baseline LV EF −12.5%, LV torsion 500 U/L, baseline Thrombus grade > 4 and total ischemic time. Average peak systolic GLS and LV torsion at echocardiography done early after myocardial infarction are independent predictors of LV remodeling after anterior STEMI and can be used to predict occurrence of LV remodeling after 6 months.
Bastawy et al. (Tue,) conducted a cohort in First anterior ST elevation myocardial infarction (n=85). Speckle tracking imaging (Global Longitudinal Strain and LV Torsion) was evaluated on Left ventricular remodeling (increase in LV EDV ≥20%) at 6 months (OR 1.7, 95% CI 0.4-13.8, p=0.04). Average peak systolic global longitudinal strain > -12.5% (OR 1.7) and LV torsion < 9.5° (OR 1.5) early after myocardial infarction independently predicted left ventricular remodeling at 6 months.