Key result
Left ventricular mechanical dispersion > 56.7 ms assessed by 3D speckle-tracking echocardiography independently predicted major adverse cardiac events (HR 1.991) in patients with STEMI.
Why the study?
The role of left ventricular mechanical dispersion estimated after an ST elevation acute myocardial infarction remains unclear.
Does left ventricular mechanical dispersion combined with global longitudinal strain assessed by 3D speckle-tracking echocardiography predict long-term MACE in patients with STEMI after primary PCI?
Cohort (n=208)
No
Does left ventricular mechanical dispersion combined with global longitudinal strain assessed by 3D speckle-tracking echocardiography predict long-term MACE in patients with STEMI after primary PCI?
Hazard Ratio: 1.991 (95% CI 1.033–3.613)
p-value: p=0.03
Left ventricular mechanical dispersion and global longitudinal strain assessed by 3D speckle-tracking echocardiography early after primary PCI for STEMI are predictive of long-term major adverse cardiac events.
Mechanical dispersion by 3D-STE was associated with post-STEMI outcomes; extends GLS utility but leaves open prospective validation before clinical adoption.
Background: The role of left ventricular (LV) mechanical dispersion estimated after an ST elevation acute myocardial infarction (STEMI) remains unclear. Methods: The study participants were 208 consecutive patients (152 men, age = 72 years) presenting with STEMI for the first time who underwent primary percutaneous coronary intervention (PCI) within 12 h of STEMI onset. Within 48 h of PCI (mean = 24 h), 2D and 3D speckle-tracking echocardiography were performed. The global longitudinal strain (GLS) was calculated using 3D (3D-GLS) and 2D (2D-GLS) speckle tracking. Mechanical dispersion was defined using the standard deviation (SD) of the time to regional peak longitudinal strain (LS) for all 16 segments for both 2D-STE and 3D-STE (2D-LS-SD, 3D-LS-SD). Infarct size was estimated by Tc99m-sestamibi as the total area of < 50% of the uptake area at 2 weeks. The patients were followed up for a longer period of time (median118months) and checked for major adverse cardiac events (MACE: cardiac death, heart failure). Results: = 94.1, p < 0.0001). Conclusions: LV mechanical dispersion besides 3D-GLS assessed by 3D-STE immediately after PCI can predict long-term prognosis.
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Iwahashi et al. (2022) conducted a cohort in ST elevation myocardial infarction (STEMI) (n=208). Left ventricular mechanical dispersion (3D-LS-SD > 56.7 ms) vs. 3D-LS-SD ≤ 56.7 ms was evaluated on Major adverse cardiac events (MACE: cardiac death, heart failure) (HR 1.991, 95% CI 1.033-3.613, p=0.03). Left ventricular mechanical dispersion > 56.7 ms assessed by 3D speckle-tracking echocardiography independently predicted major adverse cardiac events (HR 1.991) in patients with STEMI.
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