Baseline myocardial work indices assessed by 2D-STE accurately predicted post-MI LV remodeling and MACEs, which occurred in 34% of LV remodelers versus 15% of non-remodelers (p=0.01).
Cohort (n=246)
Do myocardial work indices assessed by 2D-STE predict LV remodeling and MACEs in STEMI patients with preserved LVEF after successful PCI?
Non-invasive myocardial work indices assessed by 2D-STE can accurately predict post-MI LV remodeling and MACEs in STEMI patients with preserved LVEF.
Absolute Event Rate: 34% vs 15%
p-value: p=0.01
The goal of this study was to assess whether subtle changes in myocardial work indices may predict left ventricular (LV) remodeling and major cardiac events (MACEs) in patients with a first ST-elevation acute myocardial infarction (STEMI) and preserved LVEF after successful myocardial revascularization with PCI. Methods. Consecutive STEMI patients in sinus rhythm and with an LV ejection fraction ≥ 50% following a successful PCI were recruited. Conventional and two-dimensional speckle tracking echocardiography (2D-STE) was conducted within 36 h of the PCI and 3 months later. Patients having an increase of more than 20% in LV diastolic volume were included in the LV remodeling group. MACEs were noted throughout a four-year period of follow-up. Results: The study comprised 246 STEMI patients with a mean age of 66; 72% of whom were men. In 24% (58) of the patients, LV remodeling developed. These patients were older, more frequently hypertensive, and had a smoking history. They also exhibited significantly lower baseline and 3-month values for the myocardial global index (GWI), global constructive work (GCW), and global myocardial efficiency (GWE). The cut-off values of 1670 mmHg% for GWI and 83% for GWE were predictive of LV remodeling (p < 0.0001). During the four-year follow-up period, 19% of STEMI patients experienced a MACE, involving 15% from non-LV remodelers and 34% from LV remodelers (p = 0.01). The cut-off values for baseline GWI of 1680 mmHg% and baseline GWE of 84% had the best accuracy in predicting MACEs. In conclusion, non-invasive myocardial work indices offered a reproducible and accurate method to predict post-MI LV remodeling and MACEs.
Arnăutu et al. (Sat,) conducted a cohort in ST-elevation acute myocardial infarction (STEMI) (n=246). 2D-speckle tracking echocardiography (myocardial work indices) vs. Non-LV remodelers was evaluated on LV remodeling and MACEs (p=0.01). Baseline myocardial work indices assessed by 2D-STE accurately predicted post-MI LV remodeling and MACEs, which occurred in 34% of LV remodelers versus 15% of non-remodelers (p=0.01).