Prognostic Value of Longitudinal Strain After Primary Reperfusion Therapy in Patients with Anterior-wall Acute Myocardial Infarction

Yong Hyun Park, Soo Jin Kang, Jae Kwan Song, Eun Young Lee, Jong Min Song, Duk Hyun Kang, Young Hak Kim, Cheol Whan Lee, Myeong Ki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park

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63 Citations (Scopus)

Abstract

Objectives: We sought to test whether longitudinal strain (LS) can be a useful predictor of left ventricular (LV) remodeling after reperfusion therapy in acute myocardial infarction. Background: Predicting LV remodeling based on quantification of regional contractility remains an elusive goal of echocardiography. Methods: In 50 patients with anterior-wall acute myocardial infarction, the peak systolic velocity and LS were measured by Doppler tissue imaging (LSDTI) and speckle tracking imaging (LS2D) at 7 LV segments of left anterior descending coronary artery territory after primary reperfusion therapy. LV remodeling was defined as an increase in LV end-diastolic volume of greater than or equal to 15% at follow-up echocardiography. Results: A total of 22 patients showed LV remodeling, who had significantly lower baseline ejection fraction, LSDTI, and LS2D, and higher wall-motion score index and peak creatine kinase-MB with shorter deceleration time of early diastolic mitral inflow than those without LV remodeling. LS2D (odds ratio [OR] = 1.307, 95% confidence interval [CI] = 1.082-1.579, P = .005) and LSDTI (OR = 1.430, 95% CI = 1.152-1.776, P = .001) were independent predictors of LV remodeling. During clinical follow-up of 18.3 ± 9.0 months, death or congestive heart failure developed in 11 patients (22%); LS2D (OR = 1.455, 95% CI = 1.142-1.852, P = .002) and LSDTI (OR = 1.436, 95% CI = 1.093-1.888, P = .009) were independent predictors. Conclusions: LS immediately after primary reperfusion therapy is an excellent predictor of LV remodeling and adverse events in patients with anterior-wall acute myocardial infarction.

Original languageEnglish
Pages (from-to)262-267
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume21
Issue number3
DOIs
Publication statusPublished - 2008 Mar

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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