Usefulness of Myocardial Longitudinal Strain in Prediction of Heart Failure in Patients with Successfully Reperfused Anterior Wall ST-segment Elevation Myocardial Infarction
Usefulness of Myocardial Longitudinal Strain in Prediction of Heart Failure in Patients with Successfully Reperfused Anterior Wall ST-segment Elevation Myocardial Infarction
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DOI：
10.4070/kcj.2018.0421
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发表时间：
2019-10-01
影响因子：
2.9
通讯作者：
Kim, Won-Ho
中科院分区：
文献类型：
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作者：
Lee, Sun Hwa;Lee, Sang-Rok;Kim, Won-Ho
背景和目的：急性心肌梗死相关心力衰竭(HF)与不良预后相关。本研究旨在探讨二维斑点追踪超声心动图(2D STE)测量的左前降支左前降支(LSant)的整体纵向应变(GLS)、整体周向应变(GCS)和平均纵向应变(LSant)对预测急性前壁ST段抬高性心肌梗死(ANT-STEMI)相关高频的价值。结果：发生院内和出院后心衰的患者分别为39例(22.8%)和13例(7.6%)，113例(69.6%)仍未发生心衰。多因素分析显示，GLS是唯一与院内心衰发生显著相关的因素。对于出院后心衰，LSant是唯一独立的预测因子。其他超声心动图或实验室参数与ANT-STEMI相关心衰的发生无独立关系。结论：GLS是与ANT-STEMI患者院内心衰发生有关的重要超声参数，而LSANT与ANT-STEMI再通患者出院后心衰显著相关。
Background and Objectives: Acute myocardial infarction-related heart failure (HF) is associated with poor outcome. This study was designed to investigate the usefulness of global longitudinal strain (GLS), global circumferential strain (GCS) and mean longitudinal strain of left anterior descending artery territory (LSant) measured by 2-dimensional speckle tracking echocardiography (2D STE) in prediction of acute anterior wall ST-segment elevation myocardial infarction (ant-STEMI)-related HF.Methods: A total of 171 patients with ant-STEMI who underwent successful primary coronary intervention and had available 2D STE data were enrolled. Patients were divided into 3 groups: in-hospital HF, post-discharge HF, and no-HF groups.Results: In-hospital and post-discharge HF developed in 39 (22.8%) and 13 (7.6%) of patients, respectively and 113 patients (69.6%) remained without HF. Multivariate analysis showed that GLS was the only factor significantly associated with the development of in-hospital HF. For post-discharge HF, LSant was the only independent predictor. Other echocardiographic or laboratory parameters did not show independent association with the development of ant-STEMI-related HF.Conclusions: GLS is a powerful echocardiographic parameter related to development of in-hospital HF and LSant was significantly associated with post-discharge HF in patients with successfully reperfused ant-STEMI.