Key result
Post-PCI global longitudinal strain > -14% strongly predicts 2-month LV remodeling with ~0.97 AUC.
Why the study?
Left ventricular remodelling remains a major concern after anterior STEMI treated with primary PCI despite reperfusion, necessitating early risk stratification tools.
Does speckle-tracking global longitudinal strain predict left ventricular remodelling at 2 months in patients with first anterior STEMI treated with primary PCI?
Observational (n=50)
No
Does speckle-tracking global longitudinal strain predict left ventricular remodelling at 2 months in patients with first anterior STEMI treated with primary PCI?
Effect estimate: AUC 0.969 (95% CI 0.936-1.000)
p-value: p=<0.001
Early assessment of global longitudinal strain by speckle-tracking echocardiography highly predicts left ventricular remodelling at 2 months in patients with anterior STEMI treated with primary PCI.
Objective: Despite reperfusion, LV remodelling post-AMI remains a major concern. We evaluated whether speckle-tracking GLS predicts 2‑month remodelling in first anterior STEMI patients treated with primary PCI. Methods: We prospectively studied 50 first anterior STEMI patients. Within 48 h of admission, comprehensive 2D echocardiography with speckle-tracking GLS was performed; LVEDV, LVESV, and LVEF were reassessed at 2 months. Remodelling was defined as a>20% increase in LVEDV. Results: Remodelling occurred in 23 patients (46%). Remodellers had significantly longer ischaemia (18.26±9.1 vs 4.48±2.1 h), higher LVESV (67.39±22.6 vs 41.18±16.8 mL), lower LVEF (27.95±9.8 vs 49.66±6.8%), higher E/e′ (14.04±1.3 vs 7.48±1.4), and worse GLS (–7.82±2.6 vs –15.03±2.8%; all p=0.001). ROC analysis identified GLS < –14% as predictive, yielding 100% sensitivity, 81.5% specificity, and 90% accuracy (AUC=0.969). Conclusion: Speckle-tracking GLS aids early risk stratification for LV remodelling after anterior STEMI. A threshold of > –14% (less negative) flags high‑risk patients, though multi‑centre validation is required before routine adoption
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Ibrahim et al. (2026) conducted an observational in Anterior ST-segment elevation myocardial infarction (STEMI) (n=50). Global longitudinal strain (GLS) > -14% vs. Global longitudinal strain (GLS) ≤ -14% was evaluated on Left ventricular remodelling (defined as a >20% increase in LVEDV) at 2 months (AUC 0.969, 95% CI 0.936-1.000, p=<0.001). Speckle-tracking global longitudinal strain values > -14% measured within 48 hours of primary PCI strongly predicted left ventricular remodeling at 2 months with an area under the curve of 0.969.
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