Page 92 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou
P. 92

 ABSTRACT
Left ventricular (LV) remodeling and dysfunction after ST-segment elevation myocardial infarction (STEMI) are associated with long-term outcomes. LV global longitudinal strain (GLS) after STEMI has been associated with LV remodeling at follow-up. However, little is known on the influence layer-specific components of LV GLS (endocardial, mid-myocardial and epicardial) on LV remodeling at follow-up. Therefore, we aimed at evaluating the association between layer-specific LV GLS and LV remodeling at 6 months after STEMI. Transthoracic echocardiography was performed in STEMI patients at baseline (<48h after infarction) and at 6 months follow-up. Adverse LV remodeling was defined as an increase in LV end-diastolic volume ≥20% at 6 months follow- up. Layer-specific (endocardial, mid-myocardial and epicardial) LV GLS were measured on 2-dimensional speckle tracking echocardiography at baseline. A total of 502 patients (76% male, 60 ± 11 years) were included retrospectively. When compared to patients without adverse remodeling (n=321), patients who developed adverse remodeling (n=181, 36%) demonstrated more impaired baseline LV GLS at all layers (epicardium: -10.0 ± 2.8% vs. -12.4 ± 2.8%; mid- myocardium: -12.0 ± 3.5% vs. -14.5 ± 3.2%; endocardium: -13.9 ± 4.4% vs. -16.6 ± 3.7%, respectively; p<0.001, for all). On multivariable analysis, epicardial LV GLS was the strongest correlate of adverse LV remodeling (χ2=89.3, p<0.001).In conclusion, in contemporary STEMI patients, reduced epicardial LV GLS may reflect the amount of infarct size and is a strong correlate of adverse LV remodeling at 6 months follow-up after adjusting for clinical and echocardiographic variables.

































































































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