Predictive Value of Global Longitudinal Strain on the Recovery of Left Ventricular Function Following ST-Segment Elevation Myocardial Infarction

Abstract

Background: Identifying reliable predictors for ventricular recovery at the outset is crucial for patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Objectives: This study aimed to evaluate the role of baseline global longitudinal strain (GLS) in predicting myocardial recovery following an acute infarction. Methods: We enrolled 60 consecutive patients diagnosed with STEMI and admitted to Al-Zahra Hospital for PCI from March 2022 to March 2023. Echocardiography was performed on all patients within 48 hours after revascularization to measure baseline parameters, including left ventricular ejection fraction (LVEF) and GLS. Follow-up echocardiography was conducted 6 months later to reassess LVEF. Results: At the 6-month follow-up, 38 (63.3%) patients showed a ≥ 5% improvement in LVEF, indicating ventricular recovery. The change in GLS was significantly different between the groups (recovered: -4.72 ± 2.00, not recovered: -2.41 ± 2.15, P < 0.001). A baseline GLS ≤ -4.5 and > -14.8 was predictive of either failure to recover or successful recovery of LVEF with 100% negative and positive predictive values, respectively. Baseline GLS values > -9.2 were predictive of LV recovery with 50% sensitivity and 83.3% specificity (P = 0.0002, AUC (95% confidence interval) = 0.697 (0.594, 0.799)). The type of revascularization was linked to better prediction outcomes, with patients undergoing primary and rescue PCIs more likely to recover during the follow-up period compared to those receiving deferred PCI after 24 hours (P = 0.032). Conclusions: While certain baseline GLS value thresholds may serve as predictors of LVEF recovery in patients with STEMI undergoing primary PCI, further prospective studies with larger cohorts are needed to establish more precise cut-off values.