Regional myocardial work index in the culprit vessel territory before discharge was independently associated with early adverse LV remodelling at 3 months (OR 0.602; 95% CI 0.383-0.945; P=0.027).
Cohort (n=350)
Does regional myocardial work index in the culprit vessel territory predict early LV remodelling in STEMI patients after primary PCI?
Regional myocardial work index in the culprit vessel territory assessed before discharge independently predicts early adverse LV remodelling in STEMI patients treated with primary PCI.
Effect estimate: OR 0.602 (95% CI 0.383-0.945)
p-value: p=0.027
AIMS: Adverse left ventricular (LV) remodelling after ST-segment elevation myocardial infarction (STEMI) is associated with poor outcome. Global and regional LV myocardial work (LVMW) derived from speckle tracking echocardiographic strain data in combination with non-invasive blood pressure recordings could provide information for prediction of LV remodelling after STEMI. The aim of the study was to assess the predictive value of global and regional LVMW for LV remodelling before discharge in patients with STEMI. METHODS AND RESULTS: Three-hundred and fifty STEMI patients treated with primary percutaneous coronary intervention (PCI) were included 265 men (76%), mean age: 61 ± 10 years. Clinical variables, conventional echocardiographic parameters, global and regional measures of myocardial work index (MWI), and myocardial work efficiency were recorded before discharge. The primary endpoint was early LV remodelling defined as increase in LV end-diastolic volume (LVEDV) ≥20% at 3 months after STEMI. Eighty-seven patients (25%) showed early LV remodelling. The global and regional LVMW in the culprit territory were significantly lower in patients with early LV remodelling. Peak troponin I (OR 1.109, 95% CI 1.046-1.177; P = 0.001), LVEDV (OR 0.972, 95% CI 0.959-0.984; P < 0.001) and regional MWI in the culprit vessel territory (OR 0.602, 95% CI 0.383-0.945; P = 0.027) were independently associated with early LV remodelling. CONCLUSION: In STEMI patients treated with primary PCI and optimal medical therapy, the regional cardiac work index in the culprit vessel territory before discharge is independently associated with early adverse LV remodelling.
Lustosa et al. (Mon,) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=350). Regional myocardial work index (MWI) in the culprit vessel territory was evaluated on Early LV remodelling defined as increase in LV end-diastolic volume (LVEDV) ≥20% at 3 months after STEMI (OR 0.602, 95% CI 0.383-0.945, p=0.027). Regional myocardial work index in the culprit vessel territory before discharge was independently associated with early adverse LV remodelling at 3 months (OR 0.602; 95% CI 0.383-0.945; P=0.027).
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