Understanding the role of echocardiography in remodeling after acute myocardial infarction and development of heart failure with preserved ejection fraction.

Abstract

Despite the use of reperfusion therapies in the last decades, acute myocardial infarction further remains one of the most frequentcauses of mortality. This is mainly caused by changes in the ventricular architecture leading to ventricular remodeling,followed by progressive development of heart failure. Transthoracic echocardiography is a non-invasive instrument whichcan provide information about the extent of the ischemic process and its consequences but can also predict the outcomes aftermyocardial infarction. Although standard echocardiographic parameters are currently used for risk stratification of these patients,they might not truly reflect left ventricular systolic dysfunction in acute myocardial infarct patients, since the detectionof subtle changes in the myocardial function is beyond their limits. The aim of this review is to underline the use of advancedechocardiographic parameters in identifying patients at risk for developing post-acute myocardial infarction heart failure andsubsequent adverse events. Advanced echocardiographic parameters derived from speckle tracking echocardiography providea detailed assessment on the global and regional left ventricular deformation. Therefore, speckle tracking echocardiographyhas a major role in predicting the prognosis of acute myocardial infarction patients and particularly in the development ofsubsequent heart failure, which might be prevented with early initiation of adequate therapy.