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Prognostic Significance of Left Ventricular Global Work Efficiency in Obese Patients with Acute ST-Segment Elevation

Alexandra-Cătălina Frișan1,2,3, Marius Simonescu1, Mihai-Andrei Lazăr1,2,3

  • 1Cardiology Department, "Victor Babeș" University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania.

Diagnostics (Basel, Switzerland)
|June 26, 2025
PubMed

Insights

Left ventricular global work efficiency (LVGWE) effectively predicts adverse cardiovascular events in obese patients with ST-segment elevation myocardial infarction (STEMI). Higher LVGWE (≥79%) indicates a lower risk of major adverse cardiovascular events (MACE) in this population.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Research

Background:

  • Obesity is prevalent in ST-segment elevation myocardial infarction (STEMI) patients, complicating prognosis.
  • Traditional echocardiographic metrics may be insufficient for risk stratification in obese STEMI patients.
  • Left ventricular myocardial work (LVMW) is an emerging load-adjusted marker of myocardial performance.

Purpose of the Study:

  • To evaluate the prognostic significance of LVMW in obese patients with STEMI.
  • To determine if LVMW parameters can improve risk prediction beyond traditional methods.

Main Methods:

  • 143 STEMI patients were prospectively enrolled and categorized by obesity (BMI ≥30 kg/m²).
  • Echocardiographic LVMW parameters, including left ventricular global work efficiency (LVGWE), were measured within 72 hours of admission.
  • Patients were followed for major adverse cardiovascular events (MACE), including cardiovascular death, arrhythmias, and heart failure hospitalizations.

Main Results:

  • Over a median of 13 months, 30 patients (21%) experienced MACE.
  • In obese patients, LVGWE was the strongest predictor of MACE (AUC=0.736, p=0.009), with a threshold of 79% identified.
  • Obese patients with LVGWE ≥79% had significantly lower MACE rates (log-rank p=0.006) and reduced risk (HR=5.59, p=0.019).

Conclusions:

  • LVGWE provides significant prognostic value in STEMI patients, especially in the obese subgroup.
  • LVGWE can enhance risk stratification and guide clinical management for obese STEMI patients.
  • Integrating myocardial work indices into routine echocardiography may improve outcomes in high-risk cardiovascular populations.

Keywords:
echocardiographyglobal longitudinal strainglobal work efficiencymajor adverse cardiac eventsmyocardial infarctionmyocardial workobesityspeckle tracking

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