Key result
Baseline global longitudinal strain > -12.5% independently predicted 6-month major adverse cardiovascular events in patients with STEMI (OR 0.704; 95% CI 0.597-0.829; P<0.001).
Why the study?
Predicting LV remodeling is important for outcome prediction in STEMI patients, but the predictive role of semiautomated baseline GLS was unproven.
Does baseline global longitudinal strain predict left ventricular remodeling and 6-month clinical outcomes in patients with successfully reperfused STEMI?
Cohort (n=130)
Does baseline global longitudinal strain predict left ventricular remodeling and 6-month clinical outcomes in patients with successfully reperfused STEMI?
Odds Ratio: 0.704 (95% CI 0.597–0.829)
p-value: p=< .001
Baseline global longitudinal strain > -12.5% measured within 48 hours of reperfused STEMI is a strong independent predictor of adverse left ventricular remodeling and 6-month major adverse cardiovascular events.
BACKGROUND: Predicting left ventricle (LV) remodeling is important for outcome prediction in patients with ST-segment elevation myocardial infarction (STEMI). Novel echocardiographic techniques may be beneficial for those patients. OBJECTIVES: We hypothesized that the semiautomated calculation of baseline global longitudinal strain (GLS) can predict LV remodeling and 6-month clinical outcomes in these patients. METHODS: During the period from March to December 2018, 130 patients with successful reperfusion of STEMI were prospectively included. Within 48 hours, patients underwent a baseline GLS study with follow-up study at 6 months. Patients were divided into two groups: group I: patients who showed adverse LV remodeling and group II: patients who did not. The endpoint was a composite of cardiovascular mortality, readmission due to heart failure, and urgent revascularization. RESULTS: The mean baseline GLS changed from -13.1 ± 3.5% for group I and -16.8 ± 3.1% for group II, to -10.2 ± 4.7% and -12.6 ± 3.1%, respectively, at 6-month follow-up. ROC analysis demonstrated a cutoff value of baseline GLS > -12.5% predicted LV remodeling with 64.5% sensitivity and 89% specificity (AUC 0.797, 95% CI 0.690-0.904). Multivariate logistic regression analysis model using 6-month MACEs occurrence as a dependent factor showed baseline GLS value> -12.5% to be the only significant independent predictor MACEs occurrence (OR 0.704, 95% CI 0.597-0.829, P < .001). Linear regression analysis showed that for every point estimate deterioration of baseline GLS, there was a significant corresponding 2.55 mL increase in LVEDV at 6-month follow-up (CI -4.501 to -0.612, P = .01). CONCLUSION: GLS measurement can predict remodeling and adverse clinical events in STEMI patients.
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Tawfik et al. (2020) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=130). Baseline global longitudinal strain (GLS) vs. Lower baseline GLS was evaluated on Composite of cardiovascular mortality, readmission due to heart failure, and urgent revascularization (MACEs) (OR 0.704, 95% CI 0.597-0.829, p=< .001). Baseline global longitudinal strain > -12.5% independently predicted 6-month major adverse cardiovascular events in patients with STEMI (OR 0.704; 95% CI 0.597-0.829; P<0.001).