Early prediction of ventricular functional recovery after myocardial
infarction by longitudinal strain study
Abstract
Objective There are some suggestions that global myocardial strain (GLS)
early after ST-elevation myocardial infarction (STEMI) is a predictor of
improvement in left ventricular ejection fraction (LVEF) after
myocardial infarction. The goal of this study was to evaluate predictive
value of GLS in patient with STEMI. Methods The study population
consists of 43 patients with acute STEMI and no history of prior
coronary intervention treated with primary percutaneous coronary
intervention. LVEF and myocardial strain indices were measured 48hours
and two months after STEMI by transthoracic echocardiography and speckle
tracking method. More than 5% improvement in LV EF was considered
significant improvement. Results GLS values were significantly higher in
patients with >5% improvement in LVEF 2 months after the
STEMI (GLS=15.76% in patients with >5% improvement vs.
11.54% in the other group,P <0.05). ROC analysis suggested
GLS values more than 13.5 to be a predictor of significant LVEF
improvement 2 month after STEMI. Higher GLS was observed in patients
with inferior, posterior and inferoseptal STEMI versus anterior,
extensive or anteroseptal STEMI and in patients with right coronary
occlusion versus occlusion of the left anterior descending or circumflex
arteries. Conclusion We have observed that early longitudinal LV strain
after STEMI is a predictor of during first 2 months after STEMI. This is
a useful method to predict early LV recovery after STEMI. GLS values
more than 13.5%is a significant predictor of significant LVEF
improvement.