Key result
Baseline mean global left atrial peak negative strain rate during early ventricular diastole (GLSRe) was a significant independent predictor of combined cardiovascular events in patients with NSTEAMI (HR 6.95).
Why the study?
Does left atrial function assessed by two-dimensional speckle tracking echocardiography predict combined cardiovascular events in patients with NSTEAMI?
Cohort (n=51)
No
Does left atrial function assessed by two-dimensional speckle tracking echocardiography predict combined cardiovascular events in patients with NSTEAMI?
Hazard Ratio: 6.95 (95% CI 2–24.94)
p-value: p=0.002
In patients with NSTEAMI, left atrial strain rate measured by 2D speckle tracking echocardiography provides independent prognostic value for cardiovascular events, outperforming conventional echocardiographic parameters.
GLSRe may aid risk stratification in NSTEAMI; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: The objective of this study is to evaluate left atrial(LA) function and its prognostic value by two-dimensional speckle tracking echocardiography (STE) in patients with non-ST-segment-elevation acute myocardial infarction (NSTEAMI). METHODS: Global longitudinal LA S/SR data obtained by 2D speckle imaging with automated software (Echo PAC, GE Medical). RESULTS: Clinical variables and angiographic, echocardiographic, and STE parameters were studied in 65 patients with NSTEAMI (51 males and 14 females; mean age of 60.7 ± 9.8 years) who underwent elective PCI. The final study population consisted of 51 individuals (43 males and 8 females; mean age of 62.9 ± 11.1 years) and a 12 ± 3 months follow-up was performed. A total of 22 combined cardiovascular events(20 patients) occurred. With the use of Univariable Cox regression, all parameters were evaluated in the prediction of cardiac events, ischemic events, and/or cardiac death. According to ROC analysis, baseline mean global left atrial SRs (ROC area 0.82, p = 0.001) and baseline mean global left atrial SRe (ROC area 0.68, p = 0.036) were the only predictive variables. CONCLUSIONS: In patients with NSTEAMI, we found that the novel global strain parameter of left atrial function is a valuable predictor of combined cardiovascular events over conventional echocardiography and may therefore be an important clinical tool for risk stratification in the acute phase of NSTEAMI.
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Shao et al. (2015) conducted a cohort in Non-ST-segment-elevation acute myocardial infarction (NSTEAMI) (n=51). Left atrial function assessed by two-dimensional speckle tracking echocardiography (baseline mean GLSRe) vs. Conventional echocardiography was evaluated on Combined cardiovascular events (cardiac-cause mortality and re-hospitalization due to adverse cardiac events) (HR 6.95, 95% CI 2.00-24.94, p=0.002). Baseline mean global left atrial peak negative strain rate during early ventricular diastole (GLSRe) was a significant independent predictor of combined cardiovascular events in patients with NSTEAMI (HR 6.95).
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