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- Title
The predictive value of global longitudinal strain on clinical outcome in patients with ST‐segment elevation myocardial infarction and preserved systolic function.
- Authors
Bendary, Ahmed; Tawfeek, Wael; Mahros, Mohammed; Salem, Mohamed
- Abstract
Background: Left ventricular ejection fraction (LVEF) is fundamental for risk stratification after ST‐segment elevation myocardial infarction (STEMI). However, it lacks discrimination power within normal range. Novel echocardiographic deformation parameters may be of benefit for those with post‐MI preserved LVEF. Objectives: We hypothesized that semiautomated calculation of baseline global longitudinal strain (GLS) can identify high‐risk group among patients with LVEF ≥ 50% following STEMI. Methods: During the period from January to July 2017, 110 patients with successful reperfusion of STEMI and LVEF ≥ 50% were prospectively included. Within 48 hours, patients underwent a baseline GLS study with follow‐up study at 30 days. The endpoint was a composite of cardiovascular mortality, rehospitalization for heart failure, and urgent revascularization. Results: Mean GLS value changed from −16 ± 4% at baseline to −12 ± 4% at 30‐day follow‐up (P < .001). At 30 days, cardiovascular mortality was reported in 4.5%, 11.8% were rehospitalized due to heart failure, and 5.4% underwent urgent revascularization. ROC curve analysis showed that a cutoff baseline GLS value >−12.65% predicted 30‐day MACEs with a sensitivity and specificity of 77.8% and 83.7%, respectively (AUC 0.784, 95% CI 0.646–0.921, P < .001). An adjusted multivariate logistic regression analysis revealed that baseline GLS value >−12.65% to be the only significant independent predictor for occurrence of MACEs (OR 19.54, 95% CI 6.3–61.1, P < .001). Conclusion: Early GLS calculation predicts 30‐day outcome in patients with preserved LVEF following reperfusion of STEMI.
- Subjects
CARDIOVASCULAR disease related mortality; CONFIDENCE intervals; ELECTROCARDIOGRAPHY; CARDIAC contraction; LEFT heart ventricle; HEART physiology; HEART failure; EVALUATION of medical care; MULTIVARIATE analysis; MYOCARDIAL infarction; MYOCARDIAL reperfusion; MYOCARDIAL revascularization; RISK assessment; LOGISTIC regression analysis; RECEIVER operating characteristic curves; PATIENT readmissions; ODDS ratio; VENTRICULAR ejection fraction
- Publication
Echocardiography, 2018, Vol 35, Issue 7, p915
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/echo.13866