title: Left ventricular global longitudinal systolic strain predicts adverse remodeling and subsequent cardiac events in patients with acute myocardial infarction treated with primary percutaneous coronary intervention.
abstract: To determine whether left ventricular (LV) global longitudinal strain (GLS) predicts adverse LV remodeling and cardiac events. In a prospective cohort study of patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI), we recorded clinical data and GLS, global circumferential strain and radial strain using two-dimensional speckle-tracking echocardiography of the left ventricle. At 6-month and 3-year follow-ups, patients were grouped by presence or absence of adverse LV remodeling. We used logistic regression to identify factors associated with adverse LV remodeling and a Cox model to determine the relationships between these factors and cardiac events. Of 97 patients (mean age 56 ± 12 years; 76 men), 38 showed LV remodeling. Diabetes mellitus [odds ratio (OR) 1.95% confidence interval (CI) 1.2-4.8, p = 0.05], peak troponin I (OR 1.2, 95% CI 1.1-1.3, p = 0.004), and GLS (OR 1.6, 95% CI 1.3-2.3, p = 0.009) independently predicted LV remodeling. During follow-up (22.8 ± 12.3 months), 20 patients suffered adverse events, which were independently predicted by GLS alone (OR 4.9, 95% CI 1.7-13.9, p = 0.002). Optimal GLS cutoffs for predicting adverse LV remodeling and cardiac events were >-12.46% [area under receiver operating-characteristic curve (AUC) 0.88, 95% CI 0.79-0.96, p < 0.001] and >-9.27% (AUC 0.86, 95% CI 0.64-0.98, p < 0.001), respectively. GLS measured immediately after primary PCI is an excellent predictor of adverse LV remodeling and cardiac events in patients with AMI.
authors.affiliation: Department of Cardiology, Hospital Universitario de Canarias, Ofra s/n, La Cuesta, 38320, La Laguna, Tenerife, Spain, jlacalzada@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Lacalzada
authors.forename: Alejandro
authors.initials: A
authors.lastname: de la Rosa
authors.forename: María Manuela
authors.initials: MM
authors.lastname: Izquierdo
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Jiménez
authors.forename: José Luis
authors.initials: JL
authors.lastname: Iribarren
authors.forename: Martín Jesús
authors.initials: MJ
authors.lastname: García-González
authors.forename: Belén Marí
authors.initials: BM
authors.lastname: López
authors.forename: María Amelia
authors.initials: MA
authors.lastname: Duque
authors.forename: Antonio
authors.initials: A
authors.lastname: Barragán
authors.forename: Celestino
authors.initials: C
authors.lastname: Hernández
authors.forename: María
authors.initials: M
authors.lastname: Carrillo-Pérez
authors.forename: Ignacio
authors.initials: I
authors.lastname: Laynez
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain; D013314:Stress, Mechanical; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling