Abstract 16356: Impaired Two-Dimensional Global Longitudinal Strain of Left Ventricle Predicts Long-Term Adverse Clinical Outcomes in Patients With Acute Myocardial Infarction
Background: Global longitudinal strain of left ventricle (GLSLV) is an objective parameter of myocardial function. We want to evaluate the prognostic value of GLSLV in acute myocardial infarction (AMI) patients.
Methods: From July 2011 to April 2013, all consecutive patients with AMI were included. All echocardiographic studies were done with Vivid 7 or E9 (GE medical systems) and longitudinal strains were calculated with 2-dimensional speckle tracking with EchoPAC-PC software (GE medical systems). GLSLV was calculated from the mean value of longitudinal strain of apical 4 chamber, apical 3 chamber and apical long axis views.
Results: Total 508 patients (364 males, mean 64±13 years old) were included. Of them, 223 patients (44%) were diagnosed as ST-segment elevation myocardial infarction. GLSLV had good correlations with left ventricular ejection fraction (LVEF, r=-0.79, p<0.01), regional wall motion score index (RWMSI, r=0.71, p<0.01), and log transformation of B-natriuretic peptide level (LogBNP, r=0.45 p<0.01). Seventy-two patients (14%) had complications during hospitalization (mean 6±5 days). Higher GLSLV (≥-12.5%) was associated with in-hospital complications (HR=3.94, 95% CI=2.36-6.60, p<0.01). There were 38 adverse clinical events (19 deaths, 16 hospitalizations for heart failure, 4 target lesion revascularizations and 1 AMI) during follow-up period (mean 12±6 months). GLSLV≥-12.5% was associated with adverse clinical events (HR=3.83, 95% CI=1.96-7.47, p<0.01) and death (HR=2.68, 95% CI=1.07-6.69, p=0.04) after adjustment of age and gender.
Conclusion: GLSLV showed good correlations with LVEF, RWMSI, and LogBNP. Higher GLSLV (≥-12.5%) was associated with higher incidence of in-hospital complications, adverse clinical events and death. Thus, GLSLV can be used as a good prognostic marker in AMI patients.
- © 2013 by American Heart Association, Inc.