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International Journal of Cardiology Sciences

Vol. 6, Issue 2, Part A (2024)

Predictors of myocardial functional recovery after successful reperfusion of acute St elevation myocardial infarction using speckle tracking echocardiography

Author(s):

Amir Rashad Talha, Suzan Bayoumy Alhefnawy, Mahmoud Zaki Elamrousy, Samia Mahmoud Sharafeldin and Mohamed Elsayed Elseteiha

Abstract:

Background: In those suffering from acute ST elevation myocardial infarction (STEMI), even after the restoration of blood flow in large blood vessels, the perfusion of tissue in the affected region often remains disturbed. The presence of long-lasting microcirculatory dysfunction is linked to inadequate restoration of contractile ability and unfavourable clinical results. The objective of this study was to identify the factors that may predict the restoration of myocardial function after reperfusion of acute STEMI utilising various reperfusion strategies. The assessment of myocardial function was based on the measurement of global longitudinal strain (GLS) at the 3-month mark.

Methods: This prospective non-randomized cohort work had been performed on 100 participants diagnosed with acute STEMI undergoing successful reperfusion with either primary percutaneous coronary intervention (PCI), thrombolytic therapy or pharmaco-invasive strategies, Phase I: baseline clinical characteristics and echocardiographic evaluation of left ventricular function using GLS, ejection fraction (EF), myocardial performance index (MPI), systolic myocardial excursion in all patients presented with STEMI after successful perfusion. phase II: 3 months after the index procedure clinical evaluation of the patients, assessment of GLS, LV systolic function by echocardiography, systolic myocardial excursion, myocardial performance index and detection of occurrence of any major adverse cardiac events (MACE).

Results: Regarding the left ventricular recovery assessed by GLS post 3 months of index procedure, there was better improvement in LV function in primary PCI group with GLS% ranged from -8% to -22% with mean -17.76±4.0%, while thrombolytic therapy ranged from -8% to -19% with mean -14.12±3.43%, pharmaco-invasive strategy GLS% ranged from -7% to -22% with mean -16.47±4.13%. Multivariate analyses identified that baseline EF (p<0.001, OR= -0.158), MPI (P= 0.004, OR=12.634), GLS post reperfusion (P = 0.049, OR= 0.256) are independent predictors of the myocardial recovery. Conclusions: Baseline ejection fraction, MPI, GLS post reperfusion were identified as an independent predictor of the myocardial recovery following acute myocardial infraction.

Pages: 01-06  |  43 Views  13 Downloads


International Journal of Cardiology Sciences
How to cite this article:
Amir Rashad Talha, Suzan Bayoumy Alhefnawy, Mahmoud Zaki Elamrousy, Samia Mahmoud Sharafeldin and Mohamed Elsayed Elseteiha. Predictors of myocardial functional recovery after successful reperfusion of acute St elevation myocardial infarction using speckle tracking echocardiography. Int. J. Cardiol. Sci. 2024;6(2):01-06. DOI: 10.33545/26649020.2024.v6.i1a.56