Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction.
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.
Park
Yong Hyun
YH
Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kang
Soo-Jin
SJ
Song
Jae-Kwan
JK
Lee
Eun Young
EY
Song
Jong-Min
JM
Kang
Duk-Hyun
DH
Kim
Young-Hak
YH
Lee
Cheol Whan
CW
Hong
Myeong-Ki
MK
Kim
Jae-Joong
JJ
Park
Seong-Wook
SW
Park
Seung-Jung
SJ
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*