Predictive Value of Improved and Non-Improved LV Global Longitudinal Strain in Revascularized Acute Myocardial Infarction Patients
Mahmoud Bahaa Eldin Mohammed Mohammed
Damietta Cardiology and Gastroenterology Center, Damietta, Egypt.
Mahmoud Shawky Abdelmoneum
Department of Cardiology, Faculty of Medicine, Banha University, Egypt.
Khaled Emad Eldin El-Rabbat
Department of Cardiology, Faculty of Medicine, Banha University, Egypt.
Amr Abd Elmordy Elsayed *
Department of Cardiology, Faculty of Medicine, Banha University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Echocardiographic measures predict adverse outcomes in cardiac disease patients including prior ST-segment elevation myocardial infarction (STEMI).
Aim: To assess the association between improved and non-improved global longitudinal strain (GLS) after three months of percutaneous coronary intervention (PCI)-treated acute myocardial infarction (AMI) and clinical outcomes over one year.
Patients and methods: A prospective observational study was conducted at Damietta Cardiology Center (Jan 2022 – June 2023) on 100 patients (44–73 years). They were divided into Group A (improved GLS after revascularized AMI) and Group B (non-improved GLS)
Results: GLS improvement, anterior STEMI, baseline Ejection Fraction (EF%) versus EF% after 3 months, baseline E/e ratio versus E/e ratio after 3 months, maximum Troponin T level, symptoms-to-needle time, and number of implanted stents are statistically significant predictors of Cardiovascular and Cerebrovascular Events (CCVE) occurrence (P<0.05), with an overall prediction accuracy of 92%. However, age, sex, and medical history are not statistically significant predictors of CCVE occurrence (P>0.05).
Baseline (GLS) and GLS after 3 months are statistically significant predictors of CCVE occurrence (P=0.001), with cutoff points of -7.5 and -13.0, respectively. The sensitivity and specificity for predicting CCVE occurrence are 98.4% and 86.0% for baseline GLS, and 100.0% for both sensitivity and specificity for GLS after 3 months.
Conclusion: GLS proved superior to LVEF in predicting CCVE in revascularized AMI, with baseline (-7.5) and 3-month GLS (-13) as key predictors. Improvement correlated with age, prior MI, and inferior STEMI, while non-improvement linked to anterior STEMI.
Keywords: STEMI, troponin, AMI, GLS