title: Two-Dimensional Speckle Tracking Echocardiography Predict Left Ventricular Remodeling after Acute Myocardial Infarction in Patients with Preserved Ejection Fraction.
abstract: OBJECTIVE
  Left ventricular remodeling after acute myocardial infarction increases cardiovascular events and mortality. But few study was done in patients with preserved ejection fraction (EF > 40%). We investigate whether the strain and strain rate by 2D speckle tracking echocardiography could predict left ventricular remodeling after acute myocardial infarction in this cohort.
  
  
  METHODS
  The 83 patients (average age 60.7 ± 12.3 y, 75 [90.4%] male) with new-onset acute myocardial infarction receiving echocardiography immediately, and 6 months after admission were grouped by the presence or absence of left ventricular remodeling. Strain and strain rate including longitudinal, circumferential, and radial direction were calculated. The average of strain and strain rate of which segmental longitudinal strains > - 15% were defined as the injury longitudinal strain (InjLS).
  
  
  RESULTS
  Left ventricular remodeling occurred in 24 of 83 patients (28.9%). In univariate logistic regression analyses, gender, peak CK-MB, log BNP, use of statin before discharge, wall motion score index, and InjLS were significantly associated with left ventricular remodeling (p < 0.05). In multivariate analysis using the forward stepwise method, gender, CK-MB, and InjLS were independent predictors. The hazard ratio for InjLS was 1.48 (p = 0.04). Receiver operating characteristic curve (ROC) analyses showed the area under the curve (AUC) of InjLS was largest (AUC = 0.75, cut-off value = -11.7%, sensitivity = 81%, specificity = 71%, p < 0.01). In ST-segment elevation myocardial infarction subgroup, InjLS was the only predictor according to ROC analysis (AUC = 0.79, p < 0.01, cut-off value = -11.4%, sensitivity = 88%, specificity = 77%) and multivariate logistic regression analysis (hazard ratio = 1.88, 95% CI: 1.22-2.88, p < 0.01).
  
  
  CONCLUSIONS
  InjLS was an excellent predictor for left ventricular remodeling after acute myocardial infarction in patient with preserved ejection fraction.
authors.affiliation: The Department of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Chai Yi Hsien, Taiwan.
authors.forename: Ju-Feng
authors.initials: JF
authors.lastname: Hsiao
authors.affiliation: The Department of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Chai Yi Hsien, Taiwan.
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Chung
authors.affiliation: Section of Health Informatics, Institute of Public Health, National Defense Medical Center and University, Taipei, Taiwan.
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Chu
authors.affiliation: The Department of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Chai Yi Hsien, Taiwan.
authors.forename: Yu-Shen
authors.initials: YS
authors.lastname: Lin
authors.affiliation: The Department of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Chai Yi Hsien, Taiwan.
authors.forename: Kuo-Li
authors.initials: KL
authors.lastname: Pan
authors.affiliation: The Department of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Chai Yi Hsien, Taiwan.
authors.forename: Shih-Tai
authors.initials: ST
authors.lastname: Chang
authors.affiliation: The Department of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Chai Yi Hsien, Taiwan.
authors.forename: Jen-Te
authors.identifier: http://orcid.org/0000-0002-6073-102X
authors.initials: JT
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism; D003402:Creatine Kinase / Q000097:blood; D003404:Creatinine / Q000097:blood; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012372:ROC Curve; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D003404:Creatinine; D003402:Creatine Kinase