Left Ventricular Strain: A Reliable Predictor of Short‑Term Outcomes in Patients With Anterior Wall Myocardial Infarction Without Heart Failure Publisher



Singh BRK ; Sethi R ; Jain N ; Chaudhry G ; Saran M ; Mishra O ; Pradhan A
Source: Advanced Biomedical Research Published:2020

Abstract

Background: Left ventricular ejection fraction (LVEF) is a key determinant in decision‑making after acute myocardial infarction (MI). Little is known of its relationship with left ventricular Strain and N‑Terminal fragment of pro‑B‑type Natriuretic Peptide (NT‑pro‑BNP) following acute anterior wall MI (AWMI). Materials and Methods: We conducted a prospective cohort study of patients with a diagnosis of acute AWMI and the absence of overt heart failure (HF). Assessment of LVEF, strain parameters on echocardiography was done, and NT‑pro‑BNP levels were obtained. Follow‑up for adverse cardiac events was done for 30 days postdischarge. Correlation of LVEF and NT‑pro‑BNP with various strain parameters were ascertained. Results: Of the total of 50 patients of AWMI enrolled, the mean LVEF in the study was 43.46 ± 3.72%.Eleven patients (22%) had adverse events at 30 days of follow‑up. Patients with adverse events had significantly higher overall peak systolic longitudinal strain (PSLS), lower mid‑region peak systolic longitudinal velocity (PSLV), and basal region PSLV. A significant negative correlation was observed between LVEF and mean Peak PSLS of combined apical plus mid regions of the left ventricle (r = −0.700). Log10‑NT‑pro BNP also showed a strong negative correlation with overall PSLV (r = −0.792) as well as regional PSLV values of combined apical plus mid (r = −0.763) and basal segments (r = −0.748). Conclusions: In patients with AWMI without HF, PSLS and PSLV are good predictors of adverse outcomes at 30‑day follow‑up. Furthermore, NT‑pro BNP can also be an indirect predictor of strain parameters on echocardiography. © 2023 Elsevier B.V., All rights reserved.