title: Value of speckle-tracking echocardiography for prediction of left ventricular remodeling in patients with ST-elevation myocardial infarction treated by primary percutaneous intervention.
abstract: BACKGROUND
  Left ventricular remodeling (LVr) is still common after ST-segment elevation myocardial infarction (STEMI). Early predictors of remodeling are being investigated. The aims of this study were to evaluate the prognostic value of speckle-tracking echocardiography for the prediction of LVr 3 months after primary percutaneous coronary intervention in patients with STEMI and to analyze the relationship between values of peak longitudinal strain of particular LV segments and relative changes of their subvolumes.
  
  
  METHODS
  Patients with first STEMI were enrolled. Baseline enzymes were collected, and electrocardiography and echocardiography (transthoracic echocardiography, speckle-tracking echocardiography, and three-dimensional studies) were preformed. Three months after myocardial infarction, two-dimensional and three-dimensional ultrasonographic studies were done.
  
  
  RESULTS
  Sixty-six patients were divided into two groups: 44 patients without LVr and 22 patients with LVr. Among 31 patients with anterior wall STEMI, the rate of LVr was 42%. On the basis of assessments of baseline and follow-up myocardial wall contractility, 1,041 segments were analyzed. All segments were divided into normal (n = 842), reversibly dysfunctional (n = 68), and irreversibly dysfunctional (n = 131). Receiver operating characteristic curve analysis showed that global longitudinal strain predicted LVr with an optimal cutoff value of -12.5% (area under the curve, 0.77). In multivariate analysis, diabetes mellitus (odds ratio, 4.61; 95% confidence interval, 1.19-18.02) and global longitudinal strain (odds ratio, 1.19; 95% confidence interval, 1.04-1.37) were determinants of LVr. Positive correlations were found between peak longitudinal strain and changes in subvolumes for all segments (R = 0.11, P = .005) and for those irreversibly dysfunctional (R = 0.22, P = .04).
  
  
  CONCLUSIONS
  In patients with STEMI treated by primary percutaneous coronary intervention, the frequency of LVr during 3-month follow-up was high and mainly affected the population with anterior wall myocardial infarction. The results of this study show the clinical value of global longitudinal strain measured by speckle-tracking echocardiography in the prediction of LVr. A moderate correlation was found between the value of peak longitudinal strain and changes in subvolumes attributed to irreversibly dysfunctional segments.
authors: Department of Cardiology, Medical University of Silesia, Katowice, Poland. tbochun@poczta.onet.pl
authors: Tomasz
authors: T
authors: Bochenek
authors: Krystian
authors: K
authors: Wita
authors: Zbigniew
authors: Z
authors: Tabor
authors: Marek
authors: M
authors: Grabka
authors: Łukasz
authors: Ł
authors: Krzych
authors: Wojciech
authors: W
authors: Wróbel
authors: Adrianna
authors: A
authors: Berger-Kucza
authors: Marek
authors: M
authors: Elżbieciak
authors: Anika
authors: A
authors: Doruchowska
authors: Maria Trusz
authors: MT
authors: Gluza
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D020257:Ventricular Remodeling