Abstract
Background
Left ventricular (LV) remodeling after acute myocardial infarction treated by primary percutaneous coronary intervention is an important precursor for the development of heart failure and important predictor of mortality. The early identification of the patients at risk of LV remodeling after acute myocardial infarction has prognostic and therapeutic implications. The global longitudinal strain (GLS) has been shown to be accurate in predicting LV remodeling after primary PCI and is a sensitive marker to identify the patients at risk of adverse LV remodeling. The study was carried out to determine the accuracy of GLS in prediction of LV remodeling after primary PCI.
Methods
The hospital based prospective analytical study including 145 patients who underwent primary percutaneous coronary intervention was conducted at Department of Cardiology, Yangon General Hospital from April 2019 to November 2021. Echocardiographic assessment of global longitudinal strain (GLS), left ventricular dimensions (LVEDV, LEVSD) were carried out within 24 hours and 3 months after primary PCI. The LV remodeling is defined as >20% increase in left ventricular end diastolic volume (LVEDV) after 3 months of acute myocardial infarction.
Results
The LV remodeling occurred in 33.8% of the study population. The baseline GLS measured within 24 hours after primary PCI predicted LV remodeling at 3 months with -8.5% cutoff value, 91% sensitivity, 31% specificity and 70% accuracy. The GLS measured 3 months after primary PCI detected LV remodeling at 3 months with -12.5% cutoff value, 78% sensitivity, 67% specificity and 74% accuracy.
Conclusion
It was found that the baseline GLS measured 24 hours after primary PCI was a sensitive marker to predict left ventricular remodeling at 3 months. It can be concluded that the baseline GLS is a useful predictor of adverse left ventricular remodeling after primary PCI.