Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction

Laima Caunite; Rinchyenkhand Myagmardorj; Xavier Galloo; Dorien Laenens; Jan Stassen; Takeru Nabeta; Idit Yedidya; Maria C Meucci; Jurrien H Kuneman; Inge J van den Hoogen; Sophie E van Rosendael; Hoi Wai Wu; Victor M van den Brand; Adrian Giuca; Karlis Trusinskis; Pieter van der Bijl; Jeroen J Bax; Nina Ajmone Marsan

doi:10.1016/j.echo.2024.03.007

Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction

Laima Caunite, Rinchyenkhand Myagmardorj, Xavier Galloo, Dorien Laenens, Jan Stassen, Takeru Nabeta, Idit Yedidya, Maria C Meucci, Jurrien H Kuneman, Inge J van den Hoogen, Sophie E van Rosendael, Hoi Wai Wu, Victor M van den Brand, Adrian Giuca, Karlis Trusinskis, Pieter van der Bijl, Jeroen J Bax, Nina Ajmone Marsan

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Abstract

INTRODUCTION: After ST-segment elevation myocardial infarction (STEMI), follow-up imaging is currently recommended only in patients with left ventricular ejection fraction (LVEF) <40%. LV global longitudinal strain (GLS) showed to improve risk stratification over LVEF in these patients, but has not been thoroughly studied during follow-up. Aim of this study was to explore the changes in LVGLS after STEMI and their potential prognostic value.

MATERIALS AND METHODS: Data were analyzed from an ongoing STEMI registry. Echocardiography was performed during the index hospitalization and one year after STEMI; LVGLS was expressed as absolute value and the relative LVGLS change (ΔGLS) was calculated. The study endpoint was all-cause mortality.

RESULTS: A total of 1409 STEMI patients (age 60±11 years; 75% men), who survived at least one year after STEMI and underwent echocardiography at follow-up, were included. At one year follow-up, LVEF improved from 50±8% to 53±8% (p<0.001) and LVGLS from 14±4% to 16±3% (p<0.001). Median ΔGLS was 14 (IQR 0.5-32)% relative improvement. Starting one year after STEMI, a total of 87 patients died after a median follow-up of 69 (IQR 38-103) months. The optimal ΔGLS threshold associated with the endpoint (derived by spline curve analysis) was a relative decrease >7%. Cumulative 10-year survival was 91% in patients with ΔGLS improvement or a non-significant decrease, versus 85% in patients with ΔGLS decrease of >7% (p=0.001). On multivariate Cox regression analysis, ΔGLS decrease >7% remained independently associated with the endpoint (HR 2.5 (95% CI 1.5 - 4.1); p<0.001) after adjustment for clinical and echocardiographic parameters.

CONCLUSIONS: A significant decrease in LVGLS one year after STEMI was independently associated with long-term all-cause mortality and might help further risk stratification and management of these patients during follow-up.

Original language	English
Pages (from-to)	666-673
Number of pages	8
Journal	Journal of the American Society of Echocardiography
Volume	37
Issue number	7
Early online date	2024
DOIs	https://doi.org/10.1016/j.echo.2024.03.007
Publication status	Published - Jul 2024

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Caunite, L., Myagmardorj, R., Galloo, X., Laenens, D., Stassen, J., Nabeta, T., Yedidya, I., Meucci, M. C., Kuneman, J. H., van den Hoogen, I. J., van Rosendael, S. E., Wu, H. W., van den Brand, V. M., Giuca, A., Trusinskis, K., van der Bijl, P., Bax, J. J., & Ajmone Marsan, N. (2024). Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction. Journal of the American Society of Echocardiography, 37(7), 666-673. https://doi.org/10.1016/j.echo.2024.03.007

@article{7cbf5111826841da911ab59af4ab78e0,

title = "Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction",

abstract = "INTRODUCTION: After ST-segment elevation myocardial infarction (STEMI), follow-up imaging is currently recommended only in patients with left ventricular ejection fraction (LVEF) <40%. LV global longitudinal strain (GLS) showed to improve risk stratification over LVEF in these patients, but has not been thoroughly studied during follow-up. Aim of this study was to explore the changes in LVGLS after STEMI and their potential prognostic value.MATERIALS AND METHODS: Data were analyzed from an ongoing STEMI registry. Echocardiography was performed during the index hospitalization and one year after STEMI; LVGLS was expressed as absolute value and the relative LVGLS change (ΔGLS) was calculated. The study endpoint was all-cause mortality.RESULTS: A total of 1409 STEMI patients (age 60±11 years; 75% men), who survived at least one year after STEMI and underwent echocardiography at follow-up, were included. At one year follow-up, LVEF improved from 50±8% to 53±8% (p<0.001) and LVGLS from 14±4% to 16±3% (p<0.001). Median ΔGLS was 14 (IQR 0.5-32)% relative improvement. Starting one year after STEMI, a total of 87 patients died after a median follow-up of 69 (IQR 38-103) months. The optimal ΔGLS threshold associated with the endpoint (derived by spline curve analysis) was a relative decrease >7%. Cumulative 10-year survival was 91% in patients with ΔGLS improvement or a non-significant decrease, versus 85% in patients with ΔGLS decrease of >7% (p=0.001). On multivariate Cox regression analysis, ΔGLS decrease >7% remained independently associated with the endpoint (HR 2.5 (95% CI 1.5 - 4.1); p<0.001) after adjustment for clinical and echocardiographic parameters.CONCLUSIONS: A significant decrease in LVGLS one year after STEMI was independently associated with long-term all-cause mortality and might help further risk stratification and management of these patients during follow-up.",

author = "Laima Caunite and Rinchyenkhand Myagmardorj and Xavier Galloo and Dorien Laenens and Jan Stassen and Takeru Nabeta and Idit Yedidya and Meucci, {Maria C} and Kuneman, {Jurrien H} and {van den Hoogen}, {Inge J} and {van Rosendael}, {Sophie E} and Wu, {Hoi Wai} and {van den Brand}, {Victor M} and Adrian Giuca and Karlis Trusinskis and {van der Bijl}, Pieter and Bax, {Jeroen J} and {Ajmone Marsan}, Nina",

note = "Copyright {\textcopyright} 2024. Published by Elsevier Inc.",

year = "2024",

month = jul,

doi = "10.1016/j.echo.2024.03.007",

language = "English",

volume = "37",

pages = "666--673",

journal = "Journal of the American Society of Echocardiography",

issn = "0894-7317",

publisher = "Mosby Inc.",

number = "7",

}

Caunite, L, Myagmardorj, R, Galloo, X, Laenens, D, Stassen, J, Nabeta, T, Yedidya, I, Meucci, MC, Kuneman, JH, van den Hoogen, IJ, van Rosendael, SE, Wu, HW, van den Brand, VM, Giuca, A, Trusinskis, K, van der Bijl, P, Bax, JJ & Ajmone Marsan, N 2024, 'Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction', Journal of the American Society of Echocardiography, vol. 37, no. 7, pp. 666-673. https://doi.org/10.1016/j.echo.2024.03.007

Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction. / Caunite, Laima; Myagmardorj, Rinchyenkhand; Galloo, Xavier et al.
In: Journal of the American Society of Echocardiography, Vol. 37, No. 7, 07.2024, p. 666-673.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction

AU - Caunite, Laima

AU - Myagmardorj, Rinchyenkhand

AU - Galloo, Xavier

AU - Laenens, Dorien

AU - Stassen, Jan

AU - Nabeta, Takeru

AU - Yedidya, Idit

AU - Meucci, Maria C

AU - Kuneman, Jurrien H

AU - van den Hoogen, Inge J

AU - van Rosendael, Sophie E

AU - Wu, Hoi Wai

AU - van den Brand, Victor M

AU - Giuca, Adrian

AU - Trusinskis, Karlis

AU - van der Bijl, Pieter

AU - Bax, Jeroen J

AU - Ajmone Marsan, Nina

PY - 2024/7

Y1 - 2024/7

N2 - INTRODUCTION: After ST-segment elevation myocardial infarction (STEMI), follow-up imaging is currently recommended only in patients with left ventricular ejection fraction (LVEF) <40%. LV global longitudinal strain (GLS) showed to improve risk stratification over LVEF in these patients, but has not been thoroughly studied during follow-up. Aim of this study was to explore the changes in LVGLS after STEMI and their potential prognostic value.MATERIALS AND METHODS: Data were analyzed from an ongoing STEMI registry. Echocardiography was performed during the index hospitalization and one year after STEMI; LVGLS was expressed as absolute value and the relative LVGLS change (ΔGLS) was calculated. The study endpoint was all-cause mortality.RESULTS: A total of 1409 STEMI patients (age 60±11 years; 75% men), who survived at least one year after STEMI and underwent echocardiography at follow-up, were included. At one year follow-up, LVEF improved from 50±8% to 53±8% (p<0.001) and LVGLS from 14±4% to 16±3% (p<0.001). Median ΔGLS was 14 (IQR 0.5-32)% relative improvement. Starting one year after STEMI, a total of 87 patients died after a median follow-up of 69 (IQR 38-103) months. The optimal ΔGLS threshold associated with the endpoint (derived by spline curve analysis) was a relative decrease >7%. Cumulative 10-year survival was 91% in patients with ΔGLS improvement or a non-significant decrease, versus 85% in patients with ΔGLS decrease of >7% (p=0.001). On multivariate Cox regression analysis, ΔGLS decrease >7% remained independently associated with the endpoint (HR 2.5 (95% CI 1.5 - 4.1); p<0.001) after adjustment for clinical and echocardiographic parameters.CONCLUSIONS: A significant decrease in LVGLS one year after STEMI was independently associated with long-term all-cause mortality and might help further risk stratification and management of these patients during follow-up.

AB - INTRODUCTION: After ST-segment elevation myocardial infarction (STEMI), follow-up imaging is currently recommended only in patients with left ventricular ejection fraction (LVEF) <40%. LV global longitudinal strain (GLS) showed to improve risk stratification over LVEF in these patients, but has not been thoroughly studied during follow-up. Aim of this study was to explore the changes in LVGLS after STEMI and their potential prognostic value.MATERIALS AND METHODS: Data were analyzed from an ongoing STEMI registry. Echocardiography was performed during the index hospitalization and one year after STEMI; LVGLS was expressed as absolute value and the relative LVGLS change (ΔGLS) was calculated. The study endpoint was all-cause mortality.RESULTS: A total of 1409 STEMI patients (age 60±11 years; 75% men), who survived at least one year after STEMI and underwent echocardiography at follow-up, were included. At one year follow-up, LVEF improved from 50±8% to 53±8% (p<0.001) and LVGLS from 14±4% to 16±3% (p<0.001). Median ΔGLS was 14 (IQR 0.5-32)% relative improvement. Starting one year after STEMI, a total of 87 patients died after a median follow-up of 69 (IQR 38-103) months. The optimal ΔGLS threshold associated with the endpoint (derived by spline curve analysis) was a relative decrease >7%. Cumulative 10-year survival was 91% in patients with ΔGLS improvement or a non-significant decrease, versus 85% in patients with ΔGLS decrease of >7% (p=0.001). On multivariate Cox regression analysis, ΔGLS decrease >7% remained independently associated with the endpoint (HR 2.5 (95% CI 1.5 - 4.1); p<0.001) after adjustment for clinical and echocardiographic parameters.CONCLUSIONS: A significant decrease in LVGLS one year after STEMI was independently associated with long-term all-cause mortality and might help further risk stratification and management of these patients during follow-up.

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U2 - 10.1016/j.echo.2024.03.007

DO - 10.1016/j.echo.2024.03.007

M3 - Article

C2 - 38513963

SN - 0894-7317

VL - 37

SP - 666

EP - 673

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

IS - 7

ER -

Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients with ST-segment elevation Myocardial Infarction

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