Why the study?
Does two-dimensional speckle tracking echocardiography predict prognosis in patients after acute myocardial infarction?
Does two-dimensional speckle tracking echocardiography predict prognosis in patients after acute myocardial infarction?
Although univariate analysis suggested an association between STE strain parameters and MACE in post-AMI patients, multivariable analysis demonstrated that only left ventricular remodeling was an independent predictor of MACE.
LV remodeling but not strain independently associated with post-AMI MACE; leaves open incremental prognostic value of speckle-tracking echocardiography.
AIM: The aim of the study was to evaluate the left ventricle (LV) function with speckle tracking echocardiography (STE) and to assess its relation to prognosis in patients after acute myocardial infarction (AMI). METHODS: Sixty-three patients (F/M = 16/47 pts; 62.33 ± 11.85 years old) with AMI (NSTEMI/STEMI 24/39 pts) and successful percutaneous coronary intervention (PCI) with stent implantation (thrombolysis in myocardial infarction; TIMI 3 flow) were enrolled in this study. All patients underwent baseline two-dimensional conventional echocardiography and STE 3 days (baseline) and 30 days after PCI. All patients were followed up for cardiovascular clinical endpoints, major adverse cardiovascular endpoint (MACE), and functional status (Canadian Cardiovascular Society and New York Heart Association). RESULTS: During the follow-up (31.9 ± 5.1 months), there were 3 cardiovascular deaths, 15 patients had AMI, 2 patients had cerebral infarction, 24 patients reached the MACE. Baseline LV torsion (P = 0.035), but none of the other strain parameters were associated with the time to first unplanned cardiovascular hospitalization. Univariate analysis showed that baseline longitudinal two-chamber and four-chamber strain (sLa2 0 and sLa4 0) and the same parameters obtained 30 days after the AMI together with transverse four-chamber strain (sLa2 30, sLa4 30, and sTa4 30) were significantly associated with combined endpoint (MACE). The strongest association in the univariate analysis was found for the baseline sLa2. However, in multivariable analysis only a left ventricular remodeling (LVR - 27% pts) was significantly associated with MACE and strain parameters were not associated with the combined endpoint. CONCLUSION: The assessment of LV function with STE may improve cardiovascular risk prediction in postmyocardial infarction patients.
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Haberka et al. (2014) studied this question.
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