Left ventricular global longitudinal strain by speckle tracking echocardiography as a noninvasive predictor in evaluation of myocardial infarction

Abstract

Background: Coronary artery disease (CAD) has assumed epidemic proportions in the world. Accurate risk stratification and early invasive management when indicated can reduce morbidity and mortality substantially. The study aims to correlate left ventricular (LV) function assessed by global longitudinal strain (GLS) with the extent of CAD in patients with myocardial infarction (MI). Methods: The study was conducted in a tertiary care hospital in Southern India. A total of 105 patients admitted with a diagnosis of non ST-elevation MI were included. All patients had a detailed echocardiogram with the evaluation of LV GLS by two-dimensional speckle tracking echocardiography and ejection fraction by Simpson's method. Coronary angiogram was also done in all patients to study the coronary anatomy and the relation between CAD and LV GLS. Results: The mean age of study population was 53.9 years. Echocardiographic study revealed mean LV ejection fraction (LVEF) was 48.16 + 12.27. The mean LVEF in patients with single-vessel disease was 50.11 + 11.62; with two-vessel disease, it was 51.81 + 10.34, and in patients with triple-vessel disease, it was 41.5 + 11.8. The mean GLS in the abovementioned groups was − 15.6 + 3.33, −13.5 + 3.2, and − 11.02 + 4.14, respectively. The follow-up of patients also showed a considerably lower GLS in patients who suffered higher morbidity and mortality. Conclusion: LV GLS is a good noninvasive predictor of the burden of CAD on the angiogram and also a predictor of future cardiovascular events and mortality.

Keywords

• echocardiography
• global longitudinal strain
• left ventricular ejection fraction
• left ventricular function
• myocardial infarction