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Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania

Authors Bordejevic DA, Pârvănescu T, Petrescu L, Mornoș C, Olariu I, Crișan S, Văcărescu C, Lazăr M, Morariu VI, Citu IM, Tomescu MC, Cozma D

Received 2 December 2020

Accepted for publication 16 February 2021

Published 23 March 2021 Volume 2021:17 Pages 249—258


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Professor Garry Walsh

Diana Aurora Bordejevic,1 Tudor Pârvănescu,2 Lucian Petrescu,1 Cristian Mornoș,1 Ioan Olariu,1 Simina Crișan,1 Cristina Văcărescu,1 Mihai Lazăr,1 Vlad Ioan Morariu,2 Ioana Mihaela Citu,2 Mirela Cleopatra Tomescu,2 Dragoș Cozma1

1Cardiology Department, Institute of Cardiovascular Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 2Cardiology Department, City Hospital, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania

Correspondence: Tudor Pârvănescu; Ioana Mihaela Citu
Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, Timișoara 300041, Romania
Tel +40 724 369729
; +40 723 280 623
Fax +40 256 220636
Email [email protected]; [email protected]

Background: Patients with acute myocardial infarction (AMI) are at high risk for left ventricular (LV) remodeling and heart failure. We aimed to study whether LV strains (S) and strain rates (SR) could predict cardiac remodeling in patients with AMI having a midrange or preserved LV ejection fraction (EF) following a percutaneous coronary intervention (PCI) within the first 12 hours from the onset of symptoms.
Patients and Methods: This is a case-control observational study including patients admitted for their first AMI, either with ST-segment elevation (STEMI) or without ST elevation (NSTEMI), with an LVEF > 40% after a successful PCI. Echocardiography was repeated after 6 months, and the patients were divided into two groups, according to whether LV remodeling was determined on echocardiography.
Results: Of the 253 AMI patients (mean 66 aged ± 13 years), including 185 males (73%), 61 (24%) presented signs of LV remodeling. In univariate logistic regression analysis, age, male sex, smoking history, hypertension, hypercholesterolemia, Killip class, renal function, peak creatine phosphokinase - MB level, 2- and 3-vessel coronary artery disease (CAD), and several echocardiographic parameters were significantly associated with LV remodeling (P< 0.05). In multivariate logistic regression analysis harmed (H) LS and SR, Killip class, 3-vessel CAD, and LV end-diastolic volume were outlined as independent predictors for LV remodeling. Receiver operating characteristic curve analyses showed that HLS and HLSR were the most powerful independent predictors for LV remodeling (P< 0.001), with an area under the curve (AUC) of 0.85 (sensitivity 83%; specificity 84%; p < 0.001) and 0.77 (sensitivity 93; specificity 61%; p < 0.001), respectively. The identified cut-off values for predictor variables were HLS< − 11%, and HLSR< − 0.65s− 1.
Conclusion: We concluded that 2D-STE was the best method to evaluate LV remodeling in patients with AMI and midrange or preserved LVEF following myocardial revascularization by a PCI.

Keywords: AMI, PCI, preserved LVEF, midrange LVEF, 2D speckle tracking echocardiography, LV remodeling

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