Abstract 17711: The Combination of Dyssynchrony and Global Longitudinal Strain by 3D Speckle Tracking After ST-Elevation Myocardial Infarction is an Useful Predictor
Background: Left ventricular (LV) global strain estimated immediately after ST elevation AMI (STEMI) was reported as a predictor of LV remodeling. Furthermore, LV dyssynchrony estimated by 2D strain is also a prognosticator. We explored the usefulness of the combination of these two variable assessed by 3D speckle tracking in patients with a first STEMI.
Methods: 190 consecutive patients (131 men, age 65 years, peak CPK=3169 IU/l) presenting with a first STEMI who underwent primary PCI within 12 hours of onset were enrolled. Within 24 h of PCI, echocardiography was performed by E33. 3D speckle tracking was analyzed by 4D LV-Analysis (TOM-TEC, Germany). Global longitudinal strain was calculated (3D-GLS) and the standard deviation (SD) of time to regional peak 3D longitudinal strain (3D-Long-SD) for all 16 segments was assessed as the parameter of dyssynchrony. Final infarct size was defined using Tc99m-sestamibi as the total area of <50%uptake area at 2 weeks. Echocardiography was repeated 12 months later and LV remodeling was defined. We followed them and checked the prognosis.
Results: LV remodeling was observed in 52 patients at 12 months. Both 3D-GLS and 3D-Long-SD had significant relationships with infarct size (r2=0.236, 0.169, p<0.0001). Furthermore, both of the worst tertile of them predicted LV remodeling (Odds ratio = 0.371, 95%CI;0.182-0.753, p<0.001) (Odds ratio = 0.277, 95%CI;0.132-0.579, p<0.001). The combination of the worst tertile of these indexes gave us excellent accuracy of LV remodeling (Odds ratio = 0.221, 95%CI0.093-0.508, p<0.001). Furthermore they were able to predict their prognosis(CHF, Death).
Conclusions: In patients with a first STEMI, GLS and LV dyssynchrony assessed by 3D speckle tracking echocardiography immediately after PCI can predict final infarct size and LV remodeling. The combination of these parameters was especially useful to predict prognosis.
Author Disclosures: N. Iwahashi: None. H. Takahashi: None. Y. Matsuzawa: None. N. Maejima: None. K. Hibi: Research Grant; Modest; AstraZeneca Co., Ltd MSD Co., Ltd Solve Co., Ltd Biosensors Japan Co., Ltd Teijin Pharma Co., Ltd Terumo Co., Ltd Mochida Pharmaceutical Co., Ltd. Research Grant; Significant; Goodman Co., Ltd Medtronic Japan Co., Ltd St. Jude Medical Japan Co., Ltd. Honoraria; Modest; Daiichi-Sankyo Co., Ltd Boston Scientific Japan Co., Ltd. Consultant/Advisory Board; Modest; Terumo Co., Ltd St. Jude Medical Japan Co., Ltd. M. Kosuge: None. T. Ebina: None. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd Bayer MSD Astellas Astrazeneca Sanofi Eli Lilly Japan Research Institute for Production Development Pfizer Shionogi Kowa-souyaku Daiichi-Sankyo Mitsubishi Tanabe Nihon-Boehringer-Ingelhei. Honoraria; Modest; Astrazeneca Toa Eiyo Ltd. Honoraria; Significant; MSD Bayer Daiichi-Sankyo.
- © 2016 by American Heart Association, Inc.