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ABS20191030_0011
| Imaging: Non-Invasive | |
| Predictors of Blunted Myocardial Global Longitudinal Strain After Perfused ST-Segment Elevation Myocardial Infarction | |
| Xuan Wei1, Jun Xie2 | |
| Nanjing Medical University, China1, Nanjing Drum Tower Hospital, China2 | |
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Background:
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Methods:
We retrospectively registered STEMI patients who have accepted successful reperfusion therapy. All the participants underwent CMR within a week post-PCI. Myocardial deformation was assessed by tissue tracking. Clinic characteristics, perioperative parameters and assistant examinations were analyzed according to the groups of GLS¡Ã-11% and GLS£¼-11%.
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Results:
A total of 132 STEMI patients (mean age,[ 61.1 years ¡¾ 12.2 ]£»112men[ 60.0 years ¡¾ 12.1 ]and 20 women[ 67.3 years ¡¾ 10.9]) underwent CMR in 4.9¡¾1.9days after PCI ,97 (74%) patients have blunted GLS£¨GLS¡Ã-11%£©,which showed significantly longer first medical contact to wire (FMC-wire) time (P=0.012), a higher rate of anterior wall infraction (P=0.002), poorer initial TIMI blood flow of the culprit artery (P = 0.017) as well as higher level of TnT after surgery (P=0.001)¡¢BNP(P=0.014) and CRP (P=0.043). After adjustment for age and other related factors, anterior wall myocardial infarction (OR:5.11;95% CI:1.71-15.29 ; P =0.004) , longer FMC to wire time (per increase of 3.6hours , OR:2.01; 95% CI:1.11-3.66 ; P =0.022)and TIMI coronary flow grade 0/1(OR:4.73; 95% CI:1.44-15.54 ; P =0.01) were independently correlated with the decreased myocardial GLS measured by TT-CMR, which demonstrated the strong diagnostic performance (AUC=0.819; 95CI:0.74-0.90; p£¼0.001). In addition, the patients with GLS¡Ã-11% had lower LVEF(P<0.001 in echocardiography (UCG), P <0.001 in cardiac magnetic resonance (CMR)), larger infarct size (P<0.001 in CMR)¡¢LAD(P=0.013in UCG), LVEDV(P=0.035 in UCG), and MVO area(P£¼0.001 in CMR).
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Conclusion:
Longer FMC to wire time, anterior wall myocardial infarction and total occlusion in the culprit artery were independently correlated with the impaired myocardial GLS measured by TT-CMR after adjustment for age and other related factors.
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