Longitudinal strain in patients with STEMI using speckle tracking echocardiography. Correlation with peak infarction mass and ejection fraction

Abstract

Aim: Our objective was to assess the global longitudinal peak systolic strain (GLPSS) by speckle tracking echocardiography (STE) in patients with STEMI in the first 24 h after primary percutaneous coronary intervention (PCI) and its correlation with LV infarction size and ejection fraction. Methods and results: A total of 30 patients with STEMI (mean age: 58 ± 8 years, 25 men) were studied. All patients underwent 1ry PCI. Conventional 2D echocardiography was performed to assess left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and end systolic volume index (ESVI), while STE was performed within 24 h of 1ry PCI to assess LV GLPSS. Infarction size was estimated by myocardial perfusion imaging before hospital discharges. All patients with STEMI had low LV GLPSS (mean: −10.57 ± 2.67%). Significant inverse correlation was observed between LV GLPSS and IS (p = 0.03, r = 0.39) with the cut-off point for GLPSS, which defined large myocardial infarction size (⩾30% of LV mass), was −11.5% with 93% sensitivity and 67% specificity (AUC = 0.8). Also LV GLPSS proportionally correlated with EF (p = 0.01, r = 0.35) and inversely correlated with WMSI (p = 0.04, r = 0.5). WMSI showed the most significant correlation to IS (p = 0.0, r = 0.64). Significant correlation was observed between IS and EF (p = 0.04, r = 0.37). No significant correlation was found neither between ESVI and IS (p = 0.4, r = 0.2) nor GLPSS (p = 0.08, r = 0.33). Conclusions: Assessment of IS by echocardiography after PCI in patients with STEMI was superior with GLS and WMSI when compared with LVEF and ESVI. Since global strain is an inexpensive test, these data may be of health economic interest.

Keywords

• Longitudinal strain
• Speckle tracking echocardiography
• Infarction size
• ST-elevation myocardial infarction