Using of Two Dimensional Speckle Tracking Echocardiography to Predict Major Adverse Events and Segmental Function Recovery in Patients with Acute Myocardial Infarction and Preserved Ejection Fraction

Abstract

The aim is to investigate whether strain by 2D speckle tracking echocardiography in patients with acute myocardial infarction (AMI) and preserved ejection fraction (EF≧40%) would predict prognosis and segmental function recovery or not. Ninety patients (average age 60.7±12.3 y/o) with new-onset AMI and EF≧40% were enrolled. Echocardiographies were performed after admission (average 3.3 days) and 12 months after percutaneous coronary intervention. Segmental function recovery was defined as a decrease of ≧1 grade in segmental wall motion score. The global peak longitudinal strain (GLS), circumferential strain (CS), and radial strain (RS) were calculated via EchoPAC, version 11.0 (GE Vingmed). During follow-up (mean 23.4±12.1months), 20 patients had adverse events including 6 deaths, 3 strokes, 15 revascularizations for culprit vessels. In the multivariate Cox proportional hazard regression model for adverse events, using the forward stepwise method, only female (hazard ratio 4.65 [95% CI =1.49-14.52]) and GLS (hazard ratio 1.16 [95% CI =1.03-1.3]) were independent predictors (p < 0.05). Receiver operating characteristic curve analyses for segmental function recovery showed the area under the curves was 0.75 and optimal cut-off value of –12.5% had 67% sensitivity and 76% specificity. Global longitudinal strain by 2D speckle tracking echocardiography provided important prognostic information and could predict segmental function recovery in patients with AMI and preserved EF.