Abstract
Background: Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy, and deteriorating function, which if uninterrupted leads to congestive heart failure (CHF) and a poor clinical outcome, begins in some patients with acute myocardial infarction (AMI) even after successful percutaneous coronary intervention (PCI). Aims: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four acute myocardial infarction patients. A thorough physical examination, electrocardiography (ECG) and a complete echocardiographic assessment, including speckle tracking study, was performed two days after PCI and then a follow up echocardiography with speckle tracking study was done two months afterwards. Patients were then divided into two groups based on the presence of remodelling (R+, R-). RESULTS: at baseline study global longitudinal strain (GLS) (-11.14±0.5 VS -16.78±0.4, P<0.0001), longitudinal strain rate (LSr) (-1.01±0.05 VS -1.07±0.04, P<0.0001), culprit longitudinal strain (CulLS) (-9.74±0.59 VS -15.68±0.49, P<0.0001), culprit longitudinal strain rate (CulLSr) (-0.95±0.05 VS -1.02±0.04, P<0.0001) were all lower in group R+ than in R-. In the follow up study, all strain parameters studied were significantly lower in the R+ group than R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively) and (specificities of 95% and 96.7% respectively). CONCLUSION: Our findings show that impaired indices LV deformation detected two days after successful PCI for AMI may provide predictive value in detecting LV remodelling.
Highlights
Improvement in the early diagnosis, invasive and medical treatment of acute myocardial infarction (AMI) lead to reduction in the mortality rates associated with early and late complications of AMI
Left ventricular remodeling is characterized by progressive enlargement and change in the shape of the left ventricular (LV) cavity leading to systolic dysfunction
Eighty four patients diagnosed with acute myocardial infarction, either ST segment elevation myocardial infarction (STEMI) or non ST segment myocardial infarction (NSTEMI), were included
Summary
Improvement in the early diagnosis, invasive and medical treatment of acute myocardial infarction (AMI) lead to reduction in the mortality rates associated with early and late complications of AMI. Left ventricular remodeling is characterized by progressive enlargement and change in the shape of the LV cavity leading to systolic dysfunction. It occurs, as an adaptation to the tissue infarction, as a result of macro and microscope changes at the cardiomyocyete leading to structural and functional changes. Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy, and deteriorating function, which if uninterrupted leads to congestive heart failure (CHF) and a poor clinical outcome, begins in some patients with acute myocardial infarction (AMI) even after successful percutaneous coronary intervention (PCI). Aims: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients. CONCLUSION: Our findings show that impaired indices LV deformation detected two days after successful PCI for AMI may provide predictive value in detecting LV remodelling
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