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Echocardiographic predictors for left ventricular remodeling after acute ST elevation myocardial infarction with low risk group: Speckle tracking analysis
Hyun-Min Na2, Goo-Yeong Cho1*, JooMyung Lee3, Myung-Jin Cha3, Yeonyee E Yoon1, Seung-Pyo Lee3, Hyung-Kwan Kim3, Yong-Jin Kim3, Dae-Won Sohn3
1Seoul National University Bundang Hospital Cardiology
2Seoul National University
3Cardiovascular Center, Seoul National University Hospital
Corresponding Author: Goo-Yeong Cho ,Tel: 82317877024, Email: cardioch@snu.ac.kr
ABSTRACT
Objectives: We sought to assess echocardiac predictors of left ventricular (LV) adverse remodeling after successfully reperfused acute ST elevation myocardial infarction (STEMI). Background:
LV remodeling is commonly found in STEMI patients and it may suggest adverse outcome in acute MI. We sought to identify whether 2D strain and torsion be independent parameters for prediction of LV adverse remodeling.
Methods:
We investigated 208 patients with low-risk STEMI patients who had follow up echocardiography at 6 or more months. After clinical assessments, all patients received revascularization according to current guideline. LV remodeling was defined as > 20% increase in end-diastolic volume (EDV) at follow up.
Results:
During the follow-up (11.9 ± 5.3 months), 53 patients (25.5%) showed LV remodeling. In univariate analysis, EDV, end-systolic volume (ESV), deceleration time (DT), CK-MB, and global longitudinal strain (GLS) were associated with LV remodeling. In multivariate analysis, EDV (HR: 0.922, 95% CI: 0.897 – 0.948, p < 0.001), GLS (HR: 0.842, 95% CI: 0.728 – 0.974, p = 0.020), DT (HR: 0.989, 95% CI: 0.980 – 0.998, p = 0.023) and CK-MB (HR: 1.003, 95% CI: 1.000 – 1.005, p = 0.033) independently predicted LV remodeling. However, GCS, net twist, and twist or untwist rate were not associated with remodeling. Conclusions: Of various parameters of speckle strain, only GLS predicted adverse remodeling in STEMI patients.
Keywords: Myocardial infarction, Left ventricle, Remodeling, Strain
Volume 25, No 3
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