Left ventricular remodeling in patients with primary percutaneous coronary intervention for anterior myocardial infarction

Objectives: Evaluation of the role ofspeckle tracking echocardiography in predicting left ventricular remodeling after anterior ST elevation myocardial infarction (STEMI) and successful primary percutaneous coronary intervention (PCI). Methods: A total of 100 first anterior STEMI and successful primary PCI were evaluated and divided into two groups according to the occurrence of left ventricular (LV) remodeling; remodeling group (n=26) and non remodeling group (n=74). Conventional and speckle tracking echocardiography were performed within 3 days of admission and 3 months later.Results: Twenty-six (26%) patients had LV remodeling at 3-month follow-up. They had comparable baseline clinical and echocardiographic characteristics with the non remodeling group except for β-blockers use (P =0.043), lower LV global longitudinal (LVGLS) and circumferential (LVGCS) strain (P <0.001). An adjusted multivariate logistic regression analysis revealed that baseline LVGLS to be the only significant independent predictor for occurrence of LV remodelling (hazard ratio =1.68, 95% CI: 1.35-2.09, p = 0.001). ROC curve analysis showed that a cut-off baseline LVGLS value < -9.0% and LVGCS < -11.1 predicted 3 months LV remodelling. Conclusion: Early LV global longitudinal and circumferential strain can predict LV remodeling in anterior STEMI.