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Title: | Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients With ST-Segment Elevation Myocardial Infarction | Authors: | Caunite, Laima Myagmardorj, Rinchyenkhand Galloo, Xavier Laenens, Dorien STASSEN, Jan Nabeta, Takeru Yedidya, Idit Meucci, Maria C. Kuneman, Jurrien H. van den Hoogen, Inge J. van Rosendael, Sophie E. Wu, Hoi Wai van den Brand, Victor M. Giuca, Adrian Bax, Jeroen J. Trusinskis, Karlis van der Bijl, Pieter Marsan, Nina Ajmone |
Issue Date: | 2024 | Publisher: | MOSBY-ELSEVIER | Source: | Journal of the American Society of Echocardiography (Print), 37 (7) , p. 666 -673 | Abstract: | Introduction: After ST-segment elevation myocardial infarction (STEMI), follow-up imaging is currently recommended only in patients with left ventricular ejection fraction (LVEF) <40%. Left ventricular global longitudinal strain (LVGLS) was shown to improve risk stratification over LVEF in these patients but has not been thoroughly studied during follow-up. The aim of this study was to explore the changes in LVGLS after STEMI and their potential prognostic value. Materials and methods: Data were analyzed from an ongoing STEMI registry. Echocardiography was performed during the index hospitalization and 1 year after STEMI; LVGLS was expressed as an absolute value and the relative LVGLS change (Delta GLS) was calculated. The study end point was all-cause mortality. Results: A total of 1,409 STEMI patients (age 60 +/- 11 years; 75% men) who survived at least 1 year after STEMI and underwent echocardiography at follow-up were included. At 1-year follow-up, LVEF improved from 50% +/- 8% to 53% +/- 8% (P < .001) and LVGLS from 14% +/- 4% to 16% +/- 3% (P < .001). Median Delta GLS was 14% (interquartile range, 0.5%-32%) relative improvement. Starting 1 year after STEMI, a total of 87 patients died after a median follow-up of 69 (interquartile range, 38-103) months. The optimal Delta GLS threshold associated with the end point (derived by spline curve analysis) was a relative decrease >7%. Cumulative 10-year survival was 91% in patients with Delta GLS improvement or a nonsignificant decrease, versus 85% in patients with Delta GLS decrease of >7% (P = .001). On multivariate Cox regression analysis, Delta GLS decrease >7% remained independently associated with the end point (hazard ratio, 2.5 [95% CI, 1.5-4.1]; P < .001) after adjustment for clinical and echocardiographic parameters. Conclusions: A significant decrease in LVGLS 1 year after STEMI was independently associated with long-term all-cause mortality and might help further risk stratification and management of these patients during follow-up. | Notes: | Marsan, NA (corresponding author), Heart Lung Ctr, Dept Cardiol, Albinusdreef 2, NL-2330 RC Leiden, Netherlands. n.ajmone@lumc.nl |
Keywords: | ST-Segment elevation myocardial infarction;Left ventricular global longitudinal strain | Document URI: | http://hdl.handle.net/1942/43450 | ISSN: | 0894-7317 | DOI: | 10.1016/j.echo.2024.03.007 | ISI #: | 001267700600001 | Rights: | 2024 by the American Society of Echocardiography. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/). | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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