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. 2023 Sep 9;13(18):2896.
doi: 10.3390/diagnostics13182896.

Reduced Left Ventricular Twist Early after Acute ST-Segment Elevation Myocardial Infarction as a Predictor of Left Ventricular Adverse Remodelling

Mihai-Andrei Lazăr  1   2   3 , Ioana Ionac  2 , Constantin-Tudor Luca  1   2   3 , Lucian Petrescu  1 , Cristina Vacarescu  1   2   3 , Simina Crisan  1   2   3 , Dan Gaiță  1   2   3 , Dragos Cozma  1   2   3 , Raluca Sosdean  1   2   3 , Diana-Aurora Arnăutu  2 , Alina-Ramona Cozlac  1 , Slivia-Ana Luca  1   2   3 , Andra Gurgu  1 , Claudia Totorean  1   2   3 , Cristian Mornos  1   2   3
Affiliations

Reduced Left Ventricular Twist Early after Acute ST-Segment Elevation Myocardial Infarction as a Predictor of Left Ventricular Adverse Remodelling

Mihai-Andrei Lazăr et al. Diagnostics (Basel). .

Abstract

Background: The left ventricular (LV) remodelling process represents the main cause of heart failure after a ST-segment elevation myocardial infarction (STEMI). Speckle-tracking echocardiography (STE) can detect early deformation impairment, while also predicting LV remodelling during follow-up. The aim of this study was to investigate the STE parameters in predicting cardiac remodelling following a percutaneous coronary intervention (PCI) in STEMI patients.

Methods: The study population consisted of 60 patients with acute STEMI and no history of prior myocardial infarction treated with PCI. The patients were assessed both by conventional transthoracic and ST echocardiography in the first 12 h after admission and 6 months after the acute phase. Adverse remodelling was defined as an increase in LVEDV and/or LVESV by 15%.

Results: Adverse remodelling occurred in 26 patients (43.33%). By multivariate regression equation, the risk of adverse remodelling increases with age (by 1.1-fold), triglyceride level (by 1.009-fold), and midmyocardial radial strain (mid-RS) (1.06-fold). Increased initial twist decreases the chances of adverse remodelling (0.847-fold). The LV twist presented the largest area under the receiver operating characteristic (ROC) curve to predict adverse remodelling (AUROC = 0.648; 95% CI [0.506;0.789], p = 0.04). A twist value higher than 11° has a 76.9% specificity and a 72.7% positive predictive value for reverse remodelling at 6 months.

Keywords: ST-elevation myocardial infarction (STEMI); left ventricular layers; left ventricular remodelling; myocardial strain; speckle-tracking echocardiography; twist.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) L.S endo evolution and (B) L.S epi evolution.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve for twist to predict adverse remodelling.
See this image and copyright information in PMC

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