Why the study?
Adverse left ventricular remodelling begins in some acute myocardial infarction patients even after successful PCI, prompting evaluation of speckle tracking echocardiography to predict this remodelling.
Does two-dimensional speckle tracking echocardiography performed two days after successful PCI predict left ventricular remodeling in patients with acute myocardial infarction?
Does two-dimensional speckle tracking echocardiography performed two days after successful PCI predict left ventricular remodeling in patients with acute myocardial infarction?
Speckle tracking echocardiography indices, particularly global and culprit longitudinal strain, measured two days post-PCI can accurately predict adverse left ventricular remodeling in patients with acute myocardial infarction.
Impaired early post-PCI strain may identify post-AMI patients at risk for LVR; leaves open whether routine use improves outcomes before prospective validation.
Background: Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy, and deteriorating function, which if uninterrupted leads to congestive heart failure (CHF) and a poor clinical outcome, begins in some patients with acute myocardial infarction (AMI) even after successful percutaneous coronary intervention (PCI). Aims: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four acute myocardial infarction patients. A thorough physical examination, electrocardiography (ECG) and a complete echocardiographic assessment, including speckle tracking study, was performed two days after PCI and then a follow up echocardiography with speckle tracking study was done two months afterwards. Patients were then divided into two groups based on the presence of remodelling (R+, R-). RESULTS: at baseline study global longitudinal strain (GLS) (-11.14±0.5 VS -16.78±0.4, P<0.0001), longitudinal strain rate (LSr) (-1.01±0.05 VS -1.07±0.04, P<0.0001), culprit longitudinal strain (CulLS) (-9.74±0.59 VS -15.68±0.49, P<0.0001), culprit longitudinal strain rate (CulLSr) (-0.95±0.05 VS -1.02±0.04, P<0.0001) were all lower in group R+ than in R-. In the follow up study, all strain parameters studied were significantly lower in the R+ group than R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively) and (specificities of 95% and 96.7% respectively). CONCLUSION: Our findings show that impaired indices LV deformation detected two days after successful PCI for AMI may provide predictive value in detecting LV remodelling.
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Ibrahim et al. (2020) studied this question.
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