Association of Global Longitudinal Strain With Left Ventricular Remodeling and Left Ventricular Hypertrophy in Patients With Acute Myocardial Infarction After PCI: A Small Single‐Center Prospective Observational Study
Bing Wang, Hong Yao, Zhijian Zhu, Zhigang Lu, Yesheng PanABSTRACT
Background and Aims
Among patients with acute myocardial infarction undergoing PCI, subsequent structural alterations of the left ventricle, including left ventricular remodeling (LVR) and left ventricular hypertrophy (LVH), may contribute to later heart failure. This study examined whether GLS measured early after reperfusion could help identify patients at increased risk for these post‐infarction changes.
Methods
A total of 131 patients with AMI who underwent primary PCI at our hospital between March 2023 and October 2024 were included. GLS was assessed within 7 days after PCI using two‐dimensional speckle‐tracking echocardiography. The primary endpoints were LVR and LVH assessed at 6–12 months of follow‐up. We used logistic regression to estimate the associations of GLS with the endpoints, applied restricted cubic splines (RCS) to explore possible nonlinear trends, and conducted subgroup analyses to assess the robustness of the results.
Results
Logistic regression analyses demonstrated that impaired GLS was independently associated with a higher risk of LVR. In tertile analyses, compared with patients in T1, representing better preserved LV systolic function, those in T3, representing more impaired LV systolic function, had significantly higher risks of LVR (OR = 7.51, 95% CI: 1.41–39.96, p = 0.02) and LVH (OR = 6.15, 95% CI: 1.40–27.04, p = 0.02). RCS analysis indicated linear associations between GLS and the risks of both LVR and LVH. ROC analysis showed that the optimal GLS cut‐off values for predicting LVR and LVH were −11.54% and −11.22%, with AUCs of 0.724 and 0.774, respectively.
Conclusion
Early impairment of GLS in patients with AMI after PCI was associated with subsequent LVR and LVH, suggesting that GLS may be useful for early risk stratification in this population.