title: Prediction of Left Ventricular Remodeling after a Myocardial Infarction: Role of Myocardial Deformation: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  Left ventricular (LV) adverse or reverse remodeling after ST-segment elevation myocardial infarction (MI) is the best outcome to assess the benefit of revascularization. Speckle tracking echocardiography (STE) may accurately identify early deformation impairment, while also being predictive of LV remodeling during follow-up. This systematic analysis aimed to provide a comprehensive review of current findings on STE as a predictor of LV remodeling after MI.
  
  
  METHODS
  PubMed databases were searched through December 2014 to identify studies in adults targeting the association between LV remodeling and STE. Meta-regression was performed for longitudinal analysis.
  
  
  RESULTS
  A total of 23 prospective studies (3066 patients) were found eligible. Eleven studies reported an association between STE and adverse remodeling and twelve studies with reverse remodeling. Using peak systolic longitudinal strain, the most accurate cut-off to predict adverse remodeling and reverse remodeling ranged from -12.8% to -10.2% and from -13.7% to -9.5%, respectively. In smaller studies, assessment of circumferential strain and torsion showed additive value in predicting remodeling. Meta-regression analysis revealed that longitudinal STE was associated with adverse remodeling (pooled univariable OR = 1.27, 1.17-1.38, p<0.001; pooled multivariable OR = 1.38, 1.13-1.70, p = 0.002) while pooled ORs of longitudinal STE only tended to predict reverse remodeling (pooled OR = 0.75, 0.54-1.06, p = 0.09).
  
  
  CONCLUSIONS
  This systematic review suggests that STE is associated with changes in LV volume or function regardless of underlying mechanisms and deformation direction. Meta-regression demonstrates a strong association between peak longitudinal systolic strain and adverse remodeling. Added STE predictive value over other clinical, biological and imaging variables remains to be proven.
authors.affiliation: Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Nancy, France.|Centre d'Investigations Cliniques- Plurithématique 14-33, and Institut national de la santé et de la recherche médicale U1116, Nancy, France.|Centre Hospitalier Universitaire, Pôle de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, Nancy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huttin
authors.affiliation: Centre d'Investigations Cliniques- Plurithématique 14-33, and Institut national de la santé et de la recherche médicale U1116, Nancy, France.
authors.forename: Stefano
authors.initials: S
authors.lastname: Coiro
authors.affiliation: Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Nancy, France.|Centre Hospitalier Universitaire, Pôle de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, Nancy, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Selton-Suty
authors.affiliation: Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Nancy, France.|Centre Hospitalier Universitaire, Pôle de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, Nancy, France.|Université de Lorraine, Nancy, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.affiliation: Département de Cardiologie & CIC-IT U 804, Centre, Hospitalier Universitaire de Rennes, LTSI, Université Rennes 1, INSERM 1099, Rennes, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.affiliation: Centre Hospitalier Universitaire Limoges, Hôpital Dupuytren, Department of Cardiology, Limoges, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Magne
authors.affiliation: Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Nancy, France.|Centre Hospitalier Universitaire, Pôle de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, Nancy, France.|Université de Lorraine, Nancy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sadoul
authors.affiliation: Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Nancy, France.|Centre d'Investigations Cliniques- Plurithématique 14-33, and Institut national de la santé et de la recherche médicale U1116, Nancy, France.|Université de Lorraine, Nancy, France.
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
authors.affiliation: Centre d'Investigations Cliniques- Plurithématique 14-33, and Institut national de la santé et de la recherche médicale U1116, Nancy, France.|Université de Lorraine, Nancy, France.|Investigation Network Initiative Cardiovascular and Renal Clinical Trialists, Nancy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rossignol
authors.affiliation: Centre d'Investigations Cliniques- Plurithématique 14-33, and Institut national de la santé et de la recherche médicale U1116, Nancy, France.|Université de Lorraine, Nancy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
mesh_terms: D004452:Echocardiography / Q000379:methods; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*