Abstract 19093: Prognostic Significance of Left Ventricular Global Strain and Cardiac Sympathetic Nerve Activity in Patients with Acute Myocardial Infarction Treated with Primary Percutaneous Intervention
BACKGROUND: Left ventricular (LV) function and cardiac sympathetic nerve activity are determinants of outcome after acute myocardial infarction (AMI). The aim of this study was to study speckle-tracking global longitudinal strain (GLS) and cardiac sympathetic nerve activity assessed by 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy for early risk evaluation in AMI.
METHODS: 105 patients underwent echocardiography ≤1 week and 123I-MIBG in 3 months after primary percutaneous coronary intervention for AMI. Echocardiography was performed for LV ejection fraction, the ratio of transmitral peak E-wave velocity to peak A-wave velocity (E/A), the deceleration time of E-wave (DT), mitral regurgitation grade (MR) and GLS. Cardiac sympathetic activity was assessed by washout rate (WR) on 123I-MIBG. The end point was the composite of death, hospitalization with congestive heart failure.
RESULTS: During a mean follow-up period of 18.5 months, 10 patients experienced at least one event. EF, MR, GLS and WR were associated with the composite end point. In multivariate analysis, GLS and WR were independent prognostic predictors for unfavorable events. Patients with Strain>-20% and WR>33%, which are median values of each parameters in this study population, had less favorable outcome than other patient groups.
CONCLUSIONS: In AMI patients treated with primary percutaneous intervention, GLS and WR were superior for early risk assessment compared with other parameters. The combination of these parameters may be useful in risk stratification in these patients.
Author Disclosures: S. Matsuyama: None. T. Onishi: None. M. Chimura: None. Y. Tsukishiro: None. S. Yamada: None. Y. Taniguchi: None. Y. Yasaka: None. H. Kawai: None.
- © 2014 by American Heart Association, Inc.