Prognostic power of global 2D strain according to left ventricular ejection fraction in patients with ST elevation myocardial infarction

Myung Jin Cha, Hyun Sook Kim, Seong Hwan Kim, Jae Hyeong Park, Goo Yeong Cho

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Backgrounds We aimed to evaluate the predictive power of longitudinal and circumferential fibers according to left ventricular ejection fraction (LVEF) in successfully reperfused acute ST elevation myocardial infarction (STEMI) patients. Methods Total 691 patients (age 59±13, 20% female) underwent clinical evaluation and conventional and strain echocardiography (Global longitudinal strain (GLS), global circumferential strain (GCS)). The clinical outcome was defined as the composite of death, hospitalization for heart failure, non-fatal myocardial infarction, and ventricular arrhythmia. Results During a follow-up of 39-19 months, there were 47 (6.8%) clinical events. In multivariate Cox models adjusted clinical risk factors, age (HR 1.08, p = 0.001) and GLS (HR 1.37, p = 0.001) were independent predictors. The addition of GLS resulted in significant incremental improvement in the predictive value on LVEF (χ2 = 31.8→45.8, p<0.001), although GCS offers no additional benefit. In the subgroup analysis according to LVEF, adjusted with clinical factors, GLS was significant predictive for outcome for the patients with mildly depressed (LVEF 40-50%, HR 2.25, p<0.001) and significantly depressed (LVEF<40%, HR 1.28, p = 0.016) systolic function, although GCS and LVEF lost their power with LVEF<40%. For the patients with preserved LVEF (>50%), GLS, GCS and LVEF did not show significant predictive power. Conclusions GLS is a most powerful predictor of outcome in successfully reperfused STEMI patients, especially with depressed LV dysfunction, although GCS and LVEF lost their predictive power for the patients with significantly depressed LV function. However, GLS did not predict outcome for the patients with preserved LVEF (>50%).

Original languageEnglish
Article numbere0174160
JournalPLoS One
Volume12
Issue number3
DOIs
Publication statusPublished - 2017 Mar 1

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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