Impaired Global Longitudinal Strain Predicts Poor Prognosis in Patients With Acute ST-segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention
10.3969/j.issn.1000-3614.2024.05.004
- VernacularTitle:ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后左心室整体长轴应变损减对远期预后的影响
- Author:
Lan WANG
1
;
Yuliang MA
;
Tiangang ZHU
;
Wenying JIN
;
Bailin JIANG
;
Chengfu CAO
;
Jing WANG
Author Information
1. 北京大学人民医院 心血管内科 急性心肌梗死早期预警和干预北京市重点实验室 心血管转化医学研究中心,北京 100044
- Keywords:
ST-segment elevation myocardial infarction;
global longitudinal strain;
heart failure;
prognosis
- From:
Chinese Circulation Journal
2024;39(5):451-455
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To evaluate the impact of global longitudinal strain(GLS)for prognosis in ST-segment elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention(PCI). Methods:We enrolled 156 STEMI patients who underwent PCI and spackle tracking imaging(STI)during hospitalization from September 2020 to August 2023.Patients with Killip Ⅱ-Ⅳ at baseline were excluded,138 patients were finally included.GLS was detected by STI.Patients were divided into more impaired group(GLS>-11.7%,n=57)and less impaired group(GLS≤-11.7%,n=81)according to Youden index.Clinical characteristics and echocardiography data were analyzed.Patients were followed up for a median of 21(13,28)months.Heart failure events were compared between the two groups. Results:The peak troponin I(TnI)was significantly higher in patients with GLS>-11.7%than those with GLS≤-11.7%at admission(85 160[31 297,214 226]pg/ml vs.34 942[13 571,92 713]pg/ml,P<0.001).Culprit vessel was different between the 2 groups(P<0.001).Compared with patients with GLS≤-11.7%,patients with GLS>-11.7%had lower left ventricular ejection fraction(LVEF)([60.1±8.7]%vs.[49.2±8.3]%,P<0.001),higher proportion of regional wall motion abnormality(90.1%vs.100%,P=0.015).Both LVEF and GLS recovered in patients with GLS>-11.7%during follow-up,but remained lower as compared to patients with GLS≤-11.7%(both P<0.001).The median follow-up time was 21(13,28)months.After adjusting age,sex,culprit vessel and peak TnI,the risk of heart failure of patients with GLS>-11.7%was significant higher(HR=9.123,95%CI:1.720-43.394,P=0.009). Conclusions:STEMI patients with more impaired GLS have a higher risk of heart failure post PCI.
