GLOBAL LONGITUDINAL STRAIN IS A PREDICTOR OF HEART FAILURE IN PATIENTS WITH ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION

476 JACC April 5, 2016 Volume 67, Issue 13

Acute Coronary Syndromes GLOBAL LONGITUDINAL STRAIN IS A PREDICTOR OF HEART FAILURE IN PATIENTS WITH ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 10:00 a.m.-10:45 a.m. Session Title: Predicting Outcomes in Acute Coronary Syndromes Abstract Category: 14. Acute Coronary Syndromes: Clinical Presentation Number: 1100-004 Authors: Sun-Hwa Lee, Sookyeong Song, Ji-Young Yoon, Yisik Kim, Lae Young Jung, Kyoung-Suk Rhee, Jeikeon Chae, Wonho Kim, Jaeki Ko, Chonbuk National University Hospital, Jeonju, South Korea Background: This study is designed to investigate the usefulness of global longitudinal strain (GLS) measured by 2D speckle tracking echocardiography for prediction of CHF in patients with anterior wall AMI (ant-AMI). Methods: We enrolled 171 ant-AMI patients who underwent primary PCI and had analyzable GLS data from 2006 to 2014.

Results: Mean age was 62±13 years and male was 72.5%. Mean follow-up period was 98.9±76.6 months. Post-MI in-hospital and afterdischarge CHF developed in 39 (22.8%) and 20 (11.7%) patients, respectively. Patients with in-hospital CHF showed lower GLS and LV EF, higher RVSP, more severe MR, more number of diseased vessels, less frequent post-PCI TIMI 3 flow and higher levels of peak troponin I and hs-CRP than those without CHF. NT-proBNP levels were comparable. Logistic regression analysis showed that GLS, RVSP and hsCRP were independent predictors of in-hospital post-MI CHF (Table) and GLS was the most powerful predictor (OR 1.306, 95% CI 1.1131.532, p=0.001). For prediction of CHF after discharge, multivariate logistic regression analysis showed that age was the only independent predictor (OR 1.064, 95% CI 1.122-1.107, p=0.003). Among echocardiographic and laboratory parameters, GLS was the only predictor of after-discharge HF (OR 1.208, 95% CI 1.027-1.422, p=0.023). Conclusions: GLS was an independent predictor of CHF following ant-AMI, especially CHF during index hospitalization. It was more valuable than wide used parameters of CHF such as LV EF and NT-proBNP. Multivariate logistic regression analysis for prediction of CHF following ant-AMI Variables

Post-MI in-hospital CHF

Univariate

OR

95% CI

P value

GLS RVSP

1.357 1.079

1.178-1.563 1.032-1.129

<0.001 0.001

LV EF

0.871

0.816-0.930

<0.001

Final TIMI 3

0.213

0.054-0.835

0.026

Age

1.064

1.022-1.105

0.002

LV EF E/E’ ratio MR

1.079 1.068 0.852

1.009-1.154 1.006-1.134 1.079-3.178

0.026 0.030 0.025

Hs-CRP

1.022

Number of diseased vessels 2.098

Post-MI after-discharge CHF

GLS**

1.197

0.990-1.034 1.330-3.310 1.021-1.405

0.001

0.001 0.027

Multivariate Adjusted 95% CI OR

P value

1.306 1.058

1.113-1.532 1.103-1.115

0.001 0.038

1.021

1.007-1.035

0.004

1.064

1.022-1.107

0.003

1.208

1.027-1.422

0.023