Presence of post-systolic shortening is an independent predictor of heart failure in patients following ST-segment elevation myocardial infarction

AbstractFollowing an ischemic event post systolic shortening (PSS) may occur. We investigated the association between PSS in patients with ST-segment elevation myocardial infarction (STEMI) following primary  percutaneous coronary intervention (pPCI) and occurrence of cardiovascular events at follow-up. A total of 373 patients admitted with STEMI and treated with pPCI were prospectively included in the study cohort. All patients were examined by echocardiography a median of 2 days after admission (int erquartile range, 1–3 days). PSS was measured by color tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) in six myocardial walls from all three apical projections. During a median follow-up period of 5.4 years (interquartile range, 4.1–6.0 years), 180 events occurred: 5 9 deaths, 70 heart failures (HF) and 51 new myocardial infarctions (MI). In multivariable analysis adjusting for: age, sex, peak troponin, left ventricle ejection fraction, TIMI flow grade, left ventricle mass index, hypertension and diabetes, presence of PSS by TDI in the culprit region was associa ted with a nearly twofold increased risk of HF (HR 1.90, 95% CI 1.02–3.53, P = 0.043) and the risk of HF increased incrementally with increasing numbers of walls displaying PSS. The increased risk of HF was confirmed when assessing the post-systolic index by STE (HR 1.29 95% CI 1.09–1.53, P  = 0.003, per 1% increase). A regional analysis showed that PSS by TDI in the septal ...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research