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Original Article
Published online: 2020-02-05
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The prognostic value of left atrial and left ventricular strain in patients after ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention

Ai-Ai Chu, Ting-Ting Wu, Lu Zhang, Zheng Zhang
DOI: 10.5603/CJ.a2020.0010
·
Pubmed: 32037499

open access

Ahead of print
Original articles
Published online: 2020-02-05

Abstract

Background: Global longitudinal strain (GLS) based on two-dimensional speckle-tracking echocardiography (2D-STE) might better reflect left ventricular (LV) contractile performance than conventional parameters. Recently, left atrial (LA) strain has been used as a more accurate alternative to assessing LA performance. The aim in this study was to assess the clinical prognostic value of left ventricular GLS (LV GLS) and peak atrial longitudinal strain (PALS) in patients after ST-segment-elevation myocardial infarction (STEMI).

Methods: The study enrolled 199 patients who underwent primary percutaneous coronary intervention (pPCI) for first STEMI. Conventional and 2D-STE were performed within 48 h after pPCI. LV GLS and PALS were related to LV remodeling at 6-month follow-up and to adverse events.

Results: Diabetes mellitus, GLS and PALS independently predicted LV remodeling. With multivariable Cox proportional hazards, diabetes mellitus, GLS and PALS were predictive of adverse clinical outcomes. However, PALS did not add significant incremental value beyond LV GLS in the prediction of LV remodeling (increase in area under the receiver-operator characteristic curve [AUC]: 0.05, p = 0.24) and clinical events (even a decrease in AUC: 0.03, p = 0.69).

Conclusions: Both GLS and PALS provide independent prognostic value for adverse LV remodeling and clinical outcomes after STEMI. However, the ability of the combination of PALS and GLS to predict LV remodeling and clinical outcomes may not be superior to that of a single indicator.

Abstract

Background: Global longitudinal strain (GLS) based on two-dimensional speckle-tracking echocardiography (2D-STE) might better reflect left ventricular (LV) contractile performance than conventional parameters. Recently, left atrial (LA) strain has been used as a more accurate alternative to assessing LA performance. The aim in this study was to assess the clinical prognostic value of left ventricular GLS (LV GLS) and peak atrial longitudinal strain (PALS) in patients after ST-segment-elevation myocardial infarction (STEMI).

Methods: The study enrolled 199 patients who underwent primary percutaneous coronary intervention (pPCI) for first STEMI. Conventional and 2D-STE were performed within 48 h after pPCI. LV GLS and PALS were related to LV remodeling at 6-month follow-up and to adverse events.

Results: Diabetes mellitus, GLS and PALS independently predicted LV remodeling. With multivariable Cox proportional hazards, diabetes mellitus, GLS and PALS were predictive of adverse clinical outcomes. However, PALS did not add significant incremental value beyond LV GLS in the prediction of LV remodeling (increase in area under the receiver-operator characteristic curve [AUC]: 0.05, p = 0.24) and clinical events (even a decrease in AUC: 0.03, p = 0.69).

Conclusions: Both GLS and PALS provide independent prognostic value for adverse LV remodeling and clinical outcomes after STEMI. However, the ability of the combination of PALS and GLS to predict LV remodeling and clinical outcomes may not be superior to that of a single indicator.

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Keywords

acute myocardial infarction, atrial strain, global longitudinal strain, echocardiography, remodeling, prognosis

About this article
Title

The prognostic value of left atrial and left ventricular strain in patients after ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2020-02-05

DOI

10.5603/CJ.a2020.0010

Pubmed

32037499

Keywords

acute myocardial infarction
atrial strain
global longitudinal strain
echocardiography
remodeling
prognosis

Authors

Ai-Ai Chu
Ting-Ting Wu
Lu Zhang
Zheng Zhang

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