title: Prognostic Value of Speckle Tracking Echocardiography in Patients with ST-Elevation Myocardial Infarction Treated with Late Percutaneous Intervention.
abstract: BACKGROUND
  Left ventricular remodeling (LVr) is common after ST-segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the prognostic value of speckle tracking echocardiography (STE) for predicting LVr 6-9 months after late percutaneous coronary intervention (PCI) in patients with STEMI.
  
  
  METHODS
  Patients with first STEMI who accepted late PCI were enrolled. Echocardiography was performed within 48 hours of admission. Six to nine months after MI, an echocardiography examination was repeated. LVr was defined as >15% increase in LV end-systolic volume (LVESV) after 6 months.
  
  
  RESULTS
  One hundred and twenty-seven patients were divided into two groups: 86 patients without LVr and 41 patients with LVr. There were significant differences in the global longitudinal strain (GLS), SD of time to peak longitudinal systolic strain (longitudinal Ts-SD), longitudinal postsystolic index, radial strain (RS), and SD of time to peak radial systolic strain (Radial Ts-SD). In multivariate logistic regression analysis, the GLS(odds ratio [OR] = 0.39, 95% confidence interval [CI] = 0.26-0.57, P < 0.01), and RS(OR = 1.07, 95% CI = 1.02-1.13, P = 0.01) were determinants of LVr. A receiver operating characteristic curve showed that the GLS predicted LVr with an optimal cutoff value of -10.85 (sensitivity: 89.7%, specificity: 91.7%). During clinical follow-up for 16.9 ± 1.6 months, death or congestive heart failure developed in 12 patients (9.4%), and the baseline ejection fraction (OR = 1.91, 95% CI = 1.18-3.1, P = 0.009) and GLS (OR = 0.56, 95% CI = 0.34-0.91, P = 0.02) were independent predictors.
  
  
  CONCLUSIONS
  In patients with STEMI treated with late percutaneous coronary intervention, the GLS as measured by STE is a strong predictor of LVr and adverse events.
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Cong
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Sun
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Zhijuan
authors.initials: Z
authors.lastname: Shang
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Dechun
authors.initials: D
authors.lastname: Su
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhong
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Shulong
authors.initials: S
authors.lastname: Zhang
authors.affiliation: The First Affiliated Hospital of Dalian Medical University, Liaoning, China.
authors.forename: Yanzong
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D020257:Ventricular Remodeling / Q000502:physiology*; D055815:Young Adult
keywords: infarction; myocardial; remodeling; speckle tracking echocardiography; strain