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. 2021 Mar 23:17:249-258.
doi: 10.2147/TCRM.S295251. eCollection 2021.

Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania

Diana Aurora Bordejevic  1 , Tudor Pârvănescu  2 , Lucian Petrescu  1 , Cristian Mornoș  1 , Ioan Olariu  1 , Simina Crișan  1 , Cristina Văcărescu  1 , Mihai Lazăr  1 , Vlad Ioan Morariu  2 , Ioana Mihaela Citu  2 , Mirela Cleopatra Tomescu  2 , Dragoș Cozma  1
Affiliations

Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania

Diana Aurora Bordejevic et al. Ther Clin Risk Manag. .

Abstract

Background: Patients with acute myocardial infarction (AMI) are at high risk for left ventricular (LV) remodeling and heart failure. We aimed to study whether LV strains (S) and strain rates (SR) could predict cardiac remodeling in patients with AMI having a midrange or preserved LV ejection fraction (EF) following a percutaneous coronary intervention (PCI) within the first 12 hours from the onset of symptoms.

Patients and methods: This is a case-control observational study including patients admitted for their first AMI, either with ST-segment elevation (STEMI) or without ST elevation (NSTEMI), with an LVEF > 40% after a successful PCI. Echocardiography was repeated after 6 months, and the patients were divided into two groups, according to whether LV remodeling was determined on echocardiography.

Results: Of the 253 AMI patients (mean 66 aged ± 13 years), including 185 males (73%), 61 (24%) presented signs of LV remodeling. In univariate logistic regression analysis, age, male sex, smoking history, hypertension, hypercholesterolemia, Killip class, renal function, peak creatine phosphokinase - MB level, 2- and 3-vessel coronary artery disease (CAD), and several echocardiographic parameters were significantly associated with LV remodeling (P<0.05). In multivariate logistic regression analysis harmed (H) LS and SR, Killip class, 3-vessel CAD, and LV end-diastolic volume were outlined as independent predictors for LV remodeling. Receiver operating characteristic curve analyses showed that HLS and HLSR were the most powerful independent predictors for LV remodeling (P<0.001), with an area under the curve (AUC) of 0.85 (sensitivity 83%; specificity 84%; p <0.001) and 0.77 (sensitivity 93; specificity 61%; p <0.001), respectively. The identified cut-off values for predictor variables were HLS< -11%, and HLSR< -0.65s-1.

Conclusion: We concluded that 2D-STE was the best method to evaluate LV remodeling in patients with AMI and midrange or preserved LVEF following myocardial revascularization by a PCI.

Keywords: 2D speckle tracking echocardiography; AMI; LV remodeling; PCI; midrange LVEF; preserved LVEF.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of acute myocardial patients by age groups.
Figure 2
Figure 2
Two-dimensional speckle tracking imaging of left ventricular longitudinal strain. (A) Patient with left ventricular remodeling. (B) Patient without left ventricular remodeling.
Figure 3
Figure 3
Comparison of receiver operating characteristic curves of independent variables predictive of left ventricular remodeling.
See this image and copyright information in PMC

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