Prognostic Value of Global Longitudinal Speckle-Tracking Strain after Coronary Revascularization in Patients with Non-ST Elevation Myocardial Infarction

Eldamanhory, Ahmed Said; Shah, Mahmoud Hassan; Soliman, Ahmed Abdelshafie Hassan; Ghanem, Islam

doi:10.21608/ejhm.2023.294343

Prognostic Value of Global Longitudinal Speckle-Tracking Strain after Coronary Revascularization in Patients with Non-ST Elevation Myocardial Infarction

Document Type : Original Article

Authors

10.21608/ejhm.2023.294343

Abstract

Background: Acute myocardial ischemia is a hallmark of myocardial infarction without ST-segment elevation (NSTEMI). Using wall motion analysis and left ventricular ejection fraction, conventional echocardiography is frequently used to assess cardiac function. However, this technique may not be sufficient to explore all the complex features of NSTEMI. Speckle tracking echocardiography has been used in the context of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) multiple times in recent years.
Objective: The aim of the current study was to ascertain whether there is a global longitudinal speckle tracking strain in NSTEMI patients following coronary revascularization could be a prognostic indicator of LV remodeling.
Patients and methods: A cross-sectional study was conducted at Echocardiography and Catheterization Lab Unit of Zagazig University Hospital, on 82 patients presenting with moderate risk NSTEMI and who were candidates for early invasive coronary angiography. All patients were subjected to speckle tracking echocardiography.The patients were divided into 2 groups based on the percentage changes in LVED volume at the time of admission and the six-month follow-up. Those who experienced a minimum 15% increase in LV end-diastolic volume but no improvement in LV function were said to have LV remodeling.
Results: For the variables EF, WMSI, LVEDV, LVESV, declaration time, and GLS upon admission, between the 2 groups, there were observable differences. At six months, there was a substantial difference in the EF, WMSI, LVEDV, and LVESV between the 2 groups. GLS's cut-off value for predicting LV remodeling was -14.65%. Conclusion: Individuals with NSTEMI who underwent PCI or CABG treatment showed signs of remodeling of the LV in 48.8% of these patients. GLS at a cut-off value -14.65 %, EF at a cut-off value 50.5%, and Least vessel diameter at a cut-off value 2mm were distinct indicators of LV remodeling in patients with NSTEMI revascularized by PCI or CABG.

Keywords