Does Longitudinal Strain Predict Left Ventricular Remodeling after Myocardial Infarction?

Background: One of the most prognostically significant consequences of acute myocardial infarction (AMI) is the development of an adverse left ventricular (LV) remodeling. Objectives: The purpose of our study was to evaluate a feasibility of speckle tracking imaging (STI), in particular, global longitudinal strain (Ls) in predicting LV remodeling after AMI. Methods: A total of 82 AMI patients (mean age 57.6 ± 9.4) were included in the study. Within 48–72 hours of the onset of AMI and at a 4‐month follow‐up, two‐dimensional echocardiography was performed. The apical two‐ and four‐chamber views of the heart were analyzed offline using Echo Pac software for the assessment of strain by the STI method. LV remodeling was defined as a 15% increase from the baseline in LV end‐diastolic volume. Results: Twenty‐eight patients (34.1%) with LV remodeling at 4‐month follow‐up had comparable baseline clinical and echocardiographic characteristics with 54 patients (without LV remodeling), except for a predominance of the anterior wall MI (P < 0.01), higher leukocyte count value at admission (P < 0.01), lower ejection fraction (P < 0.05), increased end‐systolic volume (P < 0.05), and reduced global systolic Ls (P < 0.05). Multivariable logistic regression analysis revealed the systolic Ls as an independent determinant of LV remodeling after AMI. A receiver operating characteristic curve analysis showed that a cutoff value of −11.6% for the systolic Ls yielded a 78% sensitivity and a 73% specificity to predict LV remodeling in 4 months. Conclusions. Our study has shown that LV longitudinal strain assessed by STI is an independent predictor of LV remodeling after AMI. (Echocardiography 2012;29:419‐427)