title: Association between left ventricular global longitudinal strain and adverse left ventricular dilatation after ST-segment-elevation myocardial infarction.
abstract: BACKGROUND
  Myocardial infarct size is a major determinant of left ventricular (LV) remodeling after ST-segment-elevation myocardial infarction. We evaluated whether LV global longitudinal strain (GLS), proposed as a novel marker of infarct size, is associated with 3- and 6-month LV dilatation after ST-segment-elevation myocardial infarction.
  
  
  RESULTS
  In the first ST-segment-elevation myocardial infarction patients treated with primary percutaneous coronary intervention, baseline LVGLS was measured with 2-dimensional speckle-tracking echocardiography. Patients were dichotomized according to median value. The independent relationship between GLS groups and LV end-diastolic volume at 3 and 6 months (adjusted for clinical and echocardiographic variables) was assessed. The final study population comprised 1041 patients (60±12 years; 76% men). Median LVGLS was -15.0%. Patients with baseline LVGLS>-15.0% exhibited greater LV dilatation at 3 and 6 months compared with patients with GLS≤-15.0% (LV end-diastolic volume 123±44 versus 106±36 mL and 121±43 versus 102±34 mL, respectively; global group-time interaction P<0.001). This association retained the same statistical significance after adjustment for various relevant demographic, clinical, and echocardiographic characteristics. Further, net reclassification improvement index demonstrated significant incremental value of LVGLS for prediction of LV end-diastolic volume increase (0.14 [95% confidence interval, 0.00034-0.29]; P=0.04).
  
  
  CONCLUSIONS
  LVGLS before discharge after ST-segment-elevation myocardial infarction is independently associated with LV dilatation at follow-up.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Emer
authors.initials: E
authors.lastname: Joyce
authors.forename: Georgette E
authors.initials: GE
authors.lastname: Hoogslag
authors.forename: Darryl P
authors.initials: DP
authors.lastname: Leong
authors.forename: Philippe
authors.initials: P
authors.lastname: Debonnaire
authors.forename: Spyridon
authors.initials: S
authors.lastname: Katsanos
authors.forename: Helèn
authors.initials: H
authors.lastname: Boden
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: echocardiography; myocardial infarction; ventricular remodeling