Page 99 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou

In addition, the mean full wall LV GLS was significantly more preserved in patients without adverse LV remodeling vs. patients with adverse LV remodeling (-14.2±3.9% vs. -11.7±4.0%; p<0.001). Layer-specific LV GLS analysis showed more preserved LV GLS values at the endocardium (-16.6±3.7% vs. -13.9±4.4%; p<0.001), mid-myocardium (-14.5±3.2% vs. -12.0±3.5%; p<0.001) and the epicardium (-12.4±2.8% vs. -10.0±2.8%; p<0.001) in patients without adverse LV remodeling vs. patients with adverse LV remodeling. Examples of layer-specific LV GLS are shown in Figure 2.
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Figure 2. Layer-specific Left ventricular global longitudinal strain in patients with versus without adverse remodeling. (Panel A) STEMI patient without adverse remodeling (culprit vessel RCA) versus (Panel B) STEMI patient with adverse remodeling (culprit vessel RCA). Both patients have similar LVEF (47% vs. 45%), WMSI (1.44 vs, 1.13), peak CK (470 U/L vs. 475 U/L) and peak troponin levels (1.30 μg/L vs, 1.30 μg/L). However, patient A demonstrates more preserved LV GLS when compared to patient B (-16.2% vs. -10.6%). The same was observed for the layer- specific analysis.
Panel A1-B1= bull’s eye plot for global value of longitudinal strain at endocardium; Panel A2-B2= bull’s eye plot for global value of longitudinal strain at mid-myocardium; Panel A3-B3= bull’s eye plot for global value of longitudinal strain at epicardium.
ANT = anterior; ANT_SEPT = anteroseptal; Endo=endocardium; Epi=epicardium; CK = creatine phosphokinase; GLS= Global longitudinal strain; INF=inferior; LAT=lateral; LV=left ventricular; LVEF=left ventricular ejection fraction; Mid=mid-myocardium; POST=posterior; RCA=right coronary artery; SEPT=septal; STEMI= ST elevation myocardial infarction; WMSI=wall motion score index.
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