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Year : 2017  |  Volume : 27  |  Issue : 3  |  Page : 93-98

Early speckle-tracking echocardiography predicts left ventricle remodeling after acute st-segment elevation myocardial infarction

1 Department of Emergency, Noninvasive Cardiology Unit, University Hospital of Ferrara, Ferrara, Italy
2 Department of Imaging and Laboratory Medicine, Radiology Unit, University Hospital of Ferrara, Ferrara, Italy

Correspondence Address:
Donato Mele
Noninvasive Cardiology Unit, University Hospital of Ferrara, Ferrara
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcecho.jcecho_2_17

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Background: Prediction of the left ventricular remodeling (LVR) after ST-segment elevation myocardial infarction (STEMI) in patients treated with effective myocardial reperfusion is challenging. Methods: Forty-one consecutive patients (36 males, age 59 ± 10 years) with STEMI who underwent effective (TIMI III) primary coronary angioplasty were enrolled. All patients had an echocardiography and cardiac magnetic resonance (CMR) study within 72 h from revascularization. Three echocardiographic parameters including LV ejection fraction (EF), global longitudinal strain (GLS) and severe altered longitudinal strain (SAS) area by two-dimensional speckle-tracking echocardiography (2D-STE) and 3 CMR indices including LV global function index (LV-GFI), myocardial salvage index (MSI), and microvascular obstruction (MVO) were calculated. LVR was defined as an increase in CMR LV end-diastolic volume (EDV) >15% after 6 months. Results: Of 41 patients, 10 (24%) had LVR (LV-EDV from 145.1 ± 29.3 to 185.9 ± 49.8 ml, P < 0.001). A significant correlation with LV-EDV variation was found for baseline SAS area (r = 0.81), LV-GFI (r = −0.56), MVO (r = 0.55), EF (r = −0.42), GLS (r = 0.42), not for MSI (r = −0.25). At the multivariable analysis, a significant correlation remained only for the SAS area. The receiver-operating characteristic curve analysis showed that a baseline SAS area ≥15% predicts LVR with a sensitivity of 80.0% and a specificity of 90.3%. Conclusions: The SAS area evaluated by 2D-STE early in acute STEMI is a valuable predictor of LVR after 6 months. Further investigations are needed to verify its value in predicting patient survival.

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