Author + information
- Edinrin Obasare,
- Chinualumogu Nwakile,
- Talal Alnabelsi,
- Marvin Louis Roy Lu,
- Vikas Bhalla,
- Vincent Figueredo and
- Gregg Pressman
Diastolic Wall Strain (DWS) is a preload-independent estimator of left ventricular (LV) stiffness. DWS correlates with systolic and diastolic indices of LV performance by speckle tracking echocardiography. This study investigates DWS as a predictor of mortality in patients with non-ST elevation myocardial infarction (NSTEMI).
Four hundred and thirty four consecutive patients had NSTEMI; mean age was 67 ± 14 years, 51% were male, 69% African American. Mean BSA = 1.9 ± 0.3, EF = 0.49 ± 0.14, TIMI Score = 4; median peak troponin = 3.4; 42% had PCI or CABG. DWS was defined as (LVPWs - LVPWd)/LVPWs where LVPWs = left ventricular posterior wall thickness in systole and LVPWd = wall thickness in diastole.
On admission mean DWS was reduced at 0.32 ± 0.13 (normal 0.4 ± 0.07). Cox regression analysis showed a negative interaction between DWS and 1-year survival, even after adjustment for age, sex, race, TIMI score, EF, E/e', and revascularization (p < 0.02). The c-index for DWS from the ROC curve was 0.60 (95% CI: 0.53 - 0.66). The best cut-off value for DWS was 0.25 (specificity 73%, sensitivity 40%).
DWS is an independent predictor of all-cause mortality in patients with NSTEMI. This measure is easily applied during routine echocardiography. Prospective studies are warranted to investigate use of DWS in guiding treatment of patients with NSTEMI.
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: 1100-014
- 2016 American College of Cardiology Foundation