Difference in the Prognostic Impact of Left Ventricular Global Longitudinal Strain between Anterior and Nonanterior Myocardial Infarction.
BACKGROUND
Speckle tracking-derived global longitudinal strain (GLS) of left ventricle is a potent prognostic marker for patients with ST-segment elevation myocardial infarction (STEMI). The purpose of this study was to investigate the difference of prognostic impact of GLS between anterior and nonanterior myocardial infarction.


METHODS
This study included 686 patients who underwent primary percutaneous coronary intervention for their first STEMI between November 2007 and April 2012. Differences in the prognostic impact of GLS between anterior MI group and nonanterior MI group were evaluated. The composite of all-cause mortality and hospitalization for heart failure in 2 years was investigated for outcome.


RESULTS
During the follow-up period, 77 (11.2%) adverse events occurred. The anterior and nonanterior MI groups included 339 and 347 patients, respectively. Among patients with anterior MI, GLS significantly predicted 2-year outcome in an adjusted model (adjusted hazard ratio [HR] 1.186; 95% confidence interval [CI] 1.071-1.314, P = 0.001), whereas the association between GLS and mortality was weaker in the nonanterior MI group (adjusted HR 0.977; 95% CI 0.884-1.081, P = 0.657). The interaction between the infarction territory and GLS was significant (P for interaction = 0.018), indicating that GLS was a more sensitive predictor of mortality in patients with anterior MI than that in those with nonanterior MI.


CONCLUSIONS
Speckle tracking-derived GLS of left ventricle more sensitively predicted clinical outcome in patients with anterior MI than in those with nonanterior MI.
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Se Yong
SY
Jang
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Dong Heon
DH
Yang
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Nam Kyun
NK
Kim
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Chang-Yeon
CY
Kim
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Myung Hwan
MH
Bae
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Jang Hoon
JH
Lee
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Hun Sik
HS
Park
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Yongkeun
Y
Cho
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Shung Chull
SC
Chae
D015984:Causality; D015897:Comorbidity; D004452:Echocardiography / Q000706:statistics & numerical data*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000601:surgery; D015995:Prevalence; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000601:surgery
acute myocardial infarction; myocardial strain