Global longitudinal strain was a powerful independent predictor of composite clinical events (HR 1.37) and provided significant incremental prognostic value over left ventricular ejection fraction in successfully reperfused STEMI patients.
Observational (n=691)
Yes
Does global longitudinal strain (GLS) predict the composite of death, heart failure hospitalization, non-fatal MI, and ventricular arrhythmia in successfully reperfused STEMI patients?
Global longitudinal strain (GLS) provides significant incremental prognostic value over LVEF in successfully reperfused STEMI patients, particularly those with depressed LV systolic function.
Effect estimate: HR 1.37 (95% CI 1.13-1.66)
p-value: p=0.001
BACKGROUNDS: We aimed to evaluate the predictive power of longitudinal and circumferential fibers according to left ventricular ejection fraction (LVEF) in successfully reperfused acute ST elevation myocardial infarction (STEMI) patients. METHODS: Total 691 patients (age 59±13, 20% female) underwent clinical evaluation and conventional and strain echocardiography (Global longitudinal strain (GLS), global circumferential strain (GCS)). The clinical outcome was defined as the composite of death, hospitalization for heart failure, non-fatal myocardial infarction, and ventricular arrhythmia. RESULTS: During a follow-up of 39±19 months, there were 47 (6.8%) clinical events. In multivariate Cox models adjusted clinical risk factors, age (HR 1.08, p = 0.001) and GLS (HR 1.37, p = 0.001) were independent predictors. The addition of GLS resulted in significant incremental improvement in the predictive value on LVEF (χ2 = 31.8→45.8, p50%), GLS, GCS and LVEF did not show significant predictive power. CONCLUSIONS: GLS is a most powerful predictor of outcome in successfully reperfused STEMI patients, especially with depressed LV dysfunction, although GCS and LVEF lost their predictive power for the patients with significantly depressed LV function. However, GLS did not predict outcome for the patients with preserved LVEF (>50%).
Cha et al. (Thu,) conducted a observational in ST elevation myocardial infarction (STEMI) (n=691). Global longitudinal strain (GLS) vs. Left ventricular ejection fraction (LVEF) and Global circumferential strain (GCS) was evaluated on Composite of all-cause death, hospitalization for heart failure, non-fatal myocardial infarction, and ventricular arrhythmia (HR 1.37, 95% CI 1.13-1.66, p=0.001). Global longitudinal strain was a powerful independent predictor of composite clinical events (HR 1.37) and provided significant incremental prognostic value over left ventricular ejection fraction in successfully reperfused STEMI patients.