Pulse wave velocity to the global longitudinal strain ratio in survivors of myocardial infarction.

Abstract

New index of pulse wave velocity to global longitudinal peak systolic strain (PWV/GLPSS) was reported to be associated with cardiovascular damage. We evaluated the prognostic role of this metric in survivors of acute myocardial infarction (AMI). We investigated in 569 patients with AMI, whether PWV/GLPSS was associated with a composite endpoint of death, stroke or new myocardial infarction, in long-term follow-up. Left ventricular longitudinal strain was evaluated by speckle tracking, and carotid arterial stiffness (local PWV) was determined using radiofrequency data technology. During follow-up (median 1316days), 114 subjects reached composite endpoint. These subjects were significantly older (P<0.0001) and were characterized by lower ejection fraction (P<0.0001), lower GLPSS (P<0.0001), higher PWV (P=0.007) and lower PWV/GLPSS index (P<0.0001). Patients with PWV/GLPSS <-0.74 were at a significantly higher risk for the composite endpoint during the follow-up (hazard rate: 1.7; 95% confidence interval: 1.2-2.6; P<0.001). The PWV/GLPSS was additive to the predictive value of EF<35%-patients with PWV/GLPSS <-0.74 and EF<35% had the highest risk for the endpoint events. The current study shows that PWV/GLPSS index has significant, independent and additive value in predicting CV complications, in subjects with myocardial infarction.