Prognostic potential of layer-specific global longitudinal strain in patients with non-ST-segment elevated acute coronary syndrome and preserved left ventricular ejection fraction
- 3 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in The International Journal of Cardiovascular Imaging
- Vol. 37 (4), 1301-1309
- https://doi.org/10.1007/s10554-020-02119-6
Abstract
This study sought to investigate the prognostic potential of layer-specific global longitudinal strain (GLS) in predicting cardiac events among non-ST-segment elevated acute coronary syndrome (NSTE-ACS) patients with preserved LVEF. In this prospective study, we enrolled 160 consecutive NSTE-ACS patients with preserved LVEF (≥ 50%) who underwent successful percutaneous coronary intervention (PCI). Transthoracic two-dimensional echocardiography examinations were performed within 48 h of admission (before PCI). Cardiac events were defined as all-cause death, re-infarction, and hospitalization for heart failure. During a median follow-up of 30.2 months, 23 patients (14.4%) developed cardiac events. GLS for all three myocardial layers were reduced in patients with adverse outcome (all P < 0.001). Yet GLSendo (area under curves = 0.85) and GLSmid (area under curves = 0.83) showed relatively higher predictive power than GLSepi when identifying patients with cardiac events. The best cut-off value of GLSendo was − 20.8%, with a diagnostic sensitivity and specificity of 87% and 71% respectively. A significant increase in the risk of cardiac events development was shown among patients with impaired layer GLS (log-rank test, P < 0.001). In conclusion, NSTE-ACS patients with preserved LVEF, layer GLS assessed before PCI all had good abilities to predict cardiac events, which might provide more prognostic information against conventional echocardiographic risk factors.Keywords
Funding Information
- National Natural Science Foundation of China (81571681, 81671762, 81701707, 81701720)
This publication has 30 references indexed in Scilit:
- 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and InterventionsJournal of the American College of Cardiology, 2011
- Prognostic Value of Serial Global Longitudinal Strain Measured by Two-Dimensional Speckle Tracking Echocardiography in Patients With ST-Segment Elevation Myocardial InfarctionThe American Journal of Cardiology, 2011
- Prognostic importance of strain and strain rate after acute myocardial infarctionEuropean Heart Journal, 2010
- Strain Echocardiography and Wall Motion Score Index Predicts Final Infarct Size in Patients With Non–ST-Segment–Elevation Myocardial InfarctionCirculation: Cardiovascular Imaging, 2010
- Viability Assessment With Global Left Ventricular Longitudinal Strain Predicts Recovery of Left Ventricular Function After Acute Myocardial InfarctionCirculation: Cardiovascular Imaging, 2010
- Prediction of All-Cause Mortality From Global Longitudinal Speckle StrainCirculation: Cardiovascular Imaging, 2009
- Early Prediction of Infarct Size by Strain Doppler Echocardiography After Coronary ReperfusionJournal of the American College of Cardiology, 2007
- Wall motion score index and ejection fraction for risk stratification after acute myocardial infarctionAmerican Heart Journal, 2006
- Influence of Ejection Fraction on Cardiovascular Outcomes in a Broad Spectrum of Heart Failure PatientsCirculation, 2005