title: Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction.
abstract: OBJECTIVE
  We sought to test whether longitudinal strain (LS) can be a useful predictor of left ventricular (LV) remodeling after reperfusion therapy in acute myocardial infarction.
  
  
  BACKGROUND
  Predicting LV remodeling based on quantification of regional contractility remains an elusive goal of echocardiography.
  
  
  METHODS
  In 50 patients with anterior-wall acute myocardial infarction, the peak systolic velocity and LS were measured by Doppler tissue imaging (LS(DTI)) and speckle tracking imaging (LS(2D)) at 7 LV segments of left anterior descending coronary artery territory after primary reperfusion therapy. LV remodeling was defined as an increase in LV end-diastolic volume of greater than or equal to 15% at follow-up echocardiography.
  
  
  RESULTS
  A total of 22 patients showed LV remodeling, who had significantly lower baseline ejection fraction, LS(DTI), and LS(2D), and higher wall-motion score index and peak creatine kinase-MB with shorter deceleration time of early diastolic mitral inflow than those without LV remodeling. LS(2D) (odds ratio [OR] = 1.307, 95% confidence interval [CI] = 1.082-1.579, P = .005) and LS(DTI) (OR = 1.430, 95% CI = 1.152-1.776, P = .001) were independent predictors of LV remodeling. During clinical follow-up of 18.3 +/- 9.0 months, death or congestive heart failure developed in 11 patients (22%); LS(2D) (OR = 1.455, 95% CI = 1.142-1.852, P = .002) and LS(DTI) (OR = 1.436, 95% CI = 1.093-1.888, P = .009) were independent predictors.
  
  
  CONCLUSIONS
  LS immediately after primary reperfusion therapy is an excellent predictor of LV remodeling and adverse events in patients with anterior-wall acute myocardial infarction.
authors: Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors: Yong Hyun
authors: YH
authors: Park
authors: Soo-Jin
authors: SJ
authors: Kang
authors: Jae-Kwan
authors: JK
authors: Song
authors: Eun Young
authors: EY
authors: Lee
authors: Jong-Min
authors: JM
authors: Song
authors: Duk-Hyun
authors: DH
authors: Kang
authors: Young-Hak
authors: YH
authors: Kim
authors: Cheol Whan
authors: CW
authors: Lee
authors: Myeong-Ki
authors: MK
authors: Hong
authors: Jae-Joong
authors: JJ
authors: Kim
authors: Seong-Wook
authors: SW
authors: Park
authors: Seung-Jung
authors: SJ
authors: Park
mesh_terms: D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D015425:Myocardial Reperfusion; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*