Association of Global Longitudinal Strain With Left Ventricular Remodeling and Left Ventricular Hypertrophy in
Bing Wang1, Hong Yao2, Zhijian Zhu1
1Department of Cardiology Jinshan Branch of Shanghai Sixth People's Hospital Shanghai China.
Insights
Early impaired Global Longitudinal Strain (GLS) in acute myocardial infarction (AMI) patients after PCI predicts left ventricular remodeling (LVR) and hypertrophy (LVH). This finding aids in early risk stratification for post-infarction cardiac changes.
Area of Science:
- Cardiology
- Echocardiography
- Myocardial Infarction
Background:
- Left ventricular remodeling (LVR) and hypertrophy (LVH) post-PCI for acute myocardial infarction (AMI) can lead to heart failure.
- Early identification of patients at risk for these structural changes is crucial.
Purpose of the Study:
- To investigate if Global Longitudinal Strain (GLS) measured early after reperfusion can identify patients at increased risk for LVR and LVH.
- To assess the association between early GLS and subsequent left ventricular structural alterations.
Main Methods:
- 131 AMI patients undergoing primary PCI were assessed for GLS within 7 days using 2D speckle-tracking echocardiography.
- Logistic regression, restricted cubic splines (RCS), and ROC analysis were used to evaluate GLS associations with LVR and LVH at 6-12 months follow-up.
Main Results:
- Impaired GLS was independently associated with a higher risk of LVR and LVH.
- Patients with the most impaired GLS (T3) showed significantly higher risks of LVR (OR=7.51) and LVH (OR=6.15) compared to those with preserved function (T1).
- Optimal GLS cut-off values for predicting LVR and LVH were -11.54% and -11.22%, respectively, with good predictive accuracy (AUCs 0.724-0.774).
Conclusions:
- Early Global Longitudinal Strain impairment in AMI patients post-PCI is linked to subsequent LVR and LVH.
- GLS serves as a valuable tool for early risk stratification in patients following myocardial infarction.
Background And Aims:
Among patients with acute myocardial infarction undergoing PCI, subsequent structural alterations of the left ventricle, including left ventricular remodeling (LVR) and left ventricular hypertrophy (LVH), may contribute to later heart failure. This study examined whether GLS measured early after reperfusion could help identify patients at increased risk for these post-infarction changes.
Methods:
A total of 131 patients with AMI who underwent primary PCI at our hospital between March 2023 and October 2024 were included. GLS was assessed within 7 days after PCI using two-dimensional speckle-tracking echocardiography. The primary endpoints were LVR and LVH assessed at 6-12 months of follow-up. We used logistic regression to estimate the associations of GLS with the endpoints, applied restricted cubic splines (RCS) to explore possible nonlinear trends, and conducted subgroup analyses to assess the robustness of the results.
Results:
Logistic regression analyses demonstrated that impaired GLS was independently associated with a higher risk of LVR. In tertile analyses, compared with patients in T1, representing better preserved LV systolic function, those in T3, representing more impaired LV systolic function, had significantly higher risks of LVR (OR = 7.51, 95% CI: 1.41-39.96, p = 0.02) and LVH (OR = 6.15, 95% CI: 1.40-27.04, p = 0.02). RCS analysis indicated linear associations between GLS and the risks of both LVR and LVH. ROC analysis showed that the optimal GLS cut-off values for predicting LVR and LVH were -11.54% and -11.22%, with AUCs of 0.724 and 0.774, respectively.
Conclusion:
Early impairment of GLS in patients with AMI after PCI was associated with subsequent LVR and LVH, suggesting that GLS may be useful for early risk stratification in this population.
