Key result
A baseline severe altered longitudinal strain area ≥15% evaluated by 2D-STE early in acute STEMI predicted left ventricular remodeling at 6 months with 80.0% sensitivity and 90.3% specificity.
Why the study?
Does early speckle-tracking echocardiography predict left ventricular remodeling in patients with STEMI treated with effective primary coronary angioplasty?
Cohort (n=41)
Does early speckle-tracking echocardiography predict left ventricular remodeling in patients with STEMI treated with effective primary coronary angioplasty?
Early evaluation of severe altered longitudinal strain (SAS) area by 2D-STE is a strong predictor of left ventricular remodeling at 6 months in STEMI patients after effective reperfusion.
May aid early LVR risk stratification by 2D-STE in STEMI; hypothesis-generating, needs prospective validation before practice change.
BACKGROUND: Prediction of the left ventricular remodeling (LVR) after ST-segment elevation myocardial infarction (STEMI) in patients treated with effective myocardial reperfusion is challenging. METHODS: Forty-one consecutive patients (36 males, age 59 ± 10 years) with STEMI who underwent effective (TIMI III) primary coronary angioplasty were enrolled. All patients had an echocardiography and cardiac magnetic resonance (CMR) study within 72 h from revascularization. Three echocardiographic parameters including LV ejection fraction (EF), global longitudinal strain (GLS) and severe altered longitudinal strain (SAS) area by two-dimensional speckle-tracking echocardiography (2D-STE) and 3 CMR indices including LV global function index (LV-GFI), myocardial salvage index (MSI), and microvascular obstruction (MVO) were calculated. LVR was defined as an increase in CMR LV end-diastolic volume (EDV) >15% after 6 months. RESULTS: = -0.25). At the multivariable analysis, a significant correlation remained only for the SAS area. The receiver-operating characteristic curve analysis showed that a baseline SAS area ≥15% predicts LVR with a sensitivity of 80.0% and a specificity of 90.3%. CONCLUSIONS: The SAS area evaluated by 2D-STE early in acute STEMI is a valuable predictor of LVR after 6 months. Further investigations are needed to verify its value in predicting patient survival.
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Mele et al. (2017) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=41). Severe altered longitudinal strain (SAS) area by 2D-STE was evaluated on Left ventricular remodeling (LVR) defined as an increase in CMR LV end-diastolic volume (EDV) >15% after 6 months. A baseline severe altered longitudinal strain area ≥15% evaluated by 2D-STE early in acute STEMI predicted left ventricular remodeling at 6 months with 80.0% sensitivity and 90.3% specificity.
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