Does Longitudinal Strain Predict Left Ventricular Remodeling after Myocardial Infarction?

BACKGROUND: One of the most prognostically significant consequences of acute myocardial infarction (AMI) is the development of an adverse left ventricular (LV) remodeling. OBJECTIVES: The purpose of our study was to evaluate a feasibility of speckle tracking imaging (STI), in particular, global longitudinal strain (Ls) in predicting LV remodeling after AMI. METHODS: A total of 82 AMI patients (mean age 57.6 ± 9.4) were included in the study. Within 48-72 hours of the onset of AMI and at a 4-month follow-up, two-dimensional echocardiography was performed. The apical two- and four-chamber views of the heart were analyzed offline using Echo Pac software for the assessment of strain by the STI method. LV remodeling was defined as a 15% increase from the baseline in LV end-diastolic volume. RESULTS: Twenty-eight patients (34.1%) with LV remodeling at 4-month follow-up had comparable baseline clinical and echocardiographic characteristics with 54 patients (without LV remodeling), except for a predominance of the anterior wall MI (P < 0.01), higher leukocyte count value at admission (P < 0.01), lower ejection fraction (P < 0.05), increased end-systolic volume (P < 0.05), and reduced global systolic Ls (P < 0.05). Multivariable logistic regression analysis revealed the systolic Ls as an independent determinant of LV remodeling after AMI. A receiver operating characteristic curve analysis showed that a cutoff value of -11.6% for the systolic Ls yielded a 78% sensitivity and a 73% specificity to predict LV remodeling in 4 months. CONCLUSIONS: Our study has shown that LV longitudinal strain assessed by STI is an independent predictor of LV remodeling after AMI.