Predictive Value of Two-dimensional Speckle Tracking Echocardiography for Left Ventricular Remodeling in Patients with Acute Myocardial Infarction with Preserved Ejection Fraction
Objective To investigate the predictive value of two-dimensional speckle tracking echocardiography(2D-STE)for left ventricular remodeling(LVR)in patients with acute myocardial infarction(AMI)with preserved ejec-tion fraction.Methods A total of 103 AMI patients with preserved ejection fraction who underwent percutaneous coro-nary intervention(PCI)in author's hospital from January 2021 to May 2023 were selected as the study subjects.The pa-tients were divided into LVR group(n=28)and non-LVR group(n=75)based on the presence or absence of LVR on postoperative echocardiography at 6 months.2D-STE examination was performed within 36h after PCI,and the global longitudin strain(GLS),global radial strain(GRS)and global circumferential strain(GCS)and infarct-related longitudi-nal strain(ILS)were recorded.Results The creatine kinase-MB isoenzyme(CK-MB)and N-terminal pro-B-type natri-uretic peptide(NT-proBNP)levels 36 h after surgery in AMI patients in LVR group were significantly higher than those in the non-LVR group,and the left ventricular end diastolic dimension(LVEDV)and left ventricular end-systolic volume(LVESV)levels were significantly lower than non-LVR group(all P＜0.05).36h after surgery,the ILS of 2D-STE strain parameter in LVR group was significantly higher than that in non-LVR group(P＜0.05);after 6 months of the follow-up,the 2D-STE strain parameters GRS of AMI patients in the LVR group was significantly lower and ILS was significantly higher than those in the non-LVR group(all P＜0.05).Multivariate Logistic regres-sion analysis showed that CK-MB and ILS were independent predictors of LVR in AMI patients with preserved ejection fraction(P＜0.05).The results of receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of ILS in predicting the occurrence of LVR in AMI patients was 0.862,the sensitivity was 85.73％and the speci-ficity was 81.32％,the predictive value AUC of ILS and CK-MB combined in predicting the occurrence of LVR in AMI patients was 0.886,the sensitivity was 92.89％and the specificity was 76.00％.Conclusion 2D-STE is an efficient,practical and reliable non-invasive technique for LVR prediction,and its parameter ILS is a good predictor of LVR risk in AMI patients with preserved ejection fraction.
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