Abstract
This prospective cohort study was conducted on fifty patients presented with STEMI and underwent primary PCI to Assess the impact of primary percutaneous coronary intervention (Primary PCI) on the left ventricular (LV) systolic function in patients with Acute STEMI using speckle tracking Echocardiography within the first 24 hrs and within 1 month after performing PCI. All patients were evaluated by history taking, clinical examination, laboratory investigations and coronary angiography assessment with revascularization of the infarct-related artery (IRA). All patients had CCU admission for 3 days. Conventional 2D echocardiography was performed within 24 h of Primary PCI to assess LV Global longitudinal peak systolic strain (GLPSS). All patients had been discharged to home with the guidelines-based medical treatment including (DAPT, Atorvastatin, ACEIs, Beta blockers). GLPSS was re-assessed after 1 month. The patients were divided into two groups: improved and non-improved, according to the improvement of LV systolic function measured by GLPSS. Improvement is defined by increase of GLPSS ≥ 10%. Our study demonstrated Improvement of LV function was based on GLPSS and was observed in 54% of the patients. Peak cardiac troponin T level, Peak creatine phosphokinase levels (CPK), LV diastolic function, and baseline GLPSS were identified as independent predictors of recovery of LV function. The patients who showed improvement of GLPSS were associated with improvement of EF (using simpson method).
Highlights
Two-dimensional (2D) and Doppler echocardiography were the central pillars of evaluating left ventricular (LV) function
The present study aimed to assess the Global longitudinal peak systolic strain (GLPSS) by Speckle Tracking Echocardiography (STE) in patients with STEMI in the first 24 hrs after primary PCI and follow-up within 1 month to assess the impact of Primary PCI on the LV systolic function and detect the prognostic predictors of improvement
The major findings of this study were: (i) During 1 month follow-up of patients after AMI, 54% of patients showed improvement of LV function. (ii) The patients who showed improvement of GLS were associated with improvement of ejection fraction (EF). (iii) Peak cardiac troponin T, Peak creatine phosphokinase levels (CPK) levels, LV diastolic function, and baseline GLS were independent predictors of improvement of LV function during follow-up
Summary
Two-dimensional (2D) and Doppler echocardiography were the central pillars of evaluating left ventricular (LV) function. Many clinicians still resort to measurements of LV ejection fraction (EF) as well as the visual analysis of myocardial wall motion when they evaluate LV global and regional performance. These methods have a significant inter-observer variability as they depend on the skills and experience of the user. The European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE) acknowledged the additional value of deformation measurements over traditional functional parameters, such as LV EF, and recommended the technique. The present study aimed to assess the GLPSS by Speckle Tracking Echocardiography (STE) in patients with STEMI in the first 24 hrs after primary PCI and follow-up within 1 month to assess the impact of Primary PCI on the LV systolic function and detect the prognostic predictors of improvement
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