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We sought to study the progress of heart failure (HF) and left ventricular remodeling (LVR) of the first onset myocardial infarction. Positive and negative values of prediction were analyzed for the patients as well as the change of myocardial systolic function after the infarction.
78 patients with first onset ST segment elevated acute myocardial infarction were enrolled. Echocardiography were performed within 24 hours of the onset, 3-month and 6-month after the infarction. At the points of follow-ups, HF was defined as LVEF failed to increase more than 5% and was lower than 35% and LVR was defined as left ventricular end-diastolic volume increased more than 20%. We compared the changes of two-dimensional and speckle tracking metrics and their relations at different time points for the predictive values of HF and LVR.
Both two-dimensional and speckle tracking metrics at 6-month follow-up were better than the baseline (P＜0.05, all). Minimal data point of longitudinal strain was the most powerful predicted factor for HF (AUC: 0.792 with sensitivity of 82% and specificity of 86%) while minimal circumferential strain was the best for the prediction of LVR (AUC: 0.821 with sensitivity of 85% and specificity of 83%). As the negative values, we found that changes of longitudinal strain from baseline to 3-month (AUC: 0.754 with sensitivity of 78% and specificity of 75%) best predicted not to be HF as the change of circumferential strain (AUC: 0.776 with sensitivity of 84% and specificity of 81%) for LVR.
Speckle tracking echocardiography has the strong power for positive and negative prediction of HF and LVR after myocardial infarction. Metrics of longitudinal strain as minimum segmental strain and change rate of strain were optimal for the prediction of HF as well as the corresponding metrics of circumferential strain for the prediction of LVR.