PREDICTORS OF LEFT VENTRICULAR REMODELING IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION TREATED BY PRIMARY PERCUTANEOUS INTERVENTION

Document Type : Original Article

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Abstract

Background: Outcomes in the treatment of STEMI have markedly improved in recent years. However, LV remodeling is still commonly present in MI patients. Early prediction of LV remodeling in MI patient is a matter of challenge.
Aim of the study: is to highlight the value of certain factors that may help in early prediction of LV remodeling after STEMI eg; ECG parameters, GLS, biomarker NT-pro BNP and angiographic factors like TIMI and MBG.
Patients and Methods: The study included 60 patients 1st acute STEMI directed , all patients were subjected to ECG analysis, admission time and GLS , NT-pro BNP, LV volume and EF, pulsed Doppler and TDI and 3 months follow up NT-pro BNP, LV volume and EF, pulsed Doppler and TDI , angiographic parameters were assessed TIMI and MBG
Results: there was a statistically significant difference between the study groups regarding, male sex, sum STR, incomplete STR, GLS, 3 months LVED and EF, three vessel disease, MBG, there was positive correlation between GLS and LV remodeling (r= 0.643, p< 0.001), there was strong negative correlation between sum STR and LV remodeling (r= - 0. 494 , p< 0.001) A ROC analysis was performed. The cut-off value of GLS that predict LV remodeling was -15.6% multivariate regression analysis showed that GLS was an independent predictor of LV remodeling.
Conclusions: Global Longitudinal strain can significantly predict adverse LV remodeling early after MI at a cut-off value - 15.6%.

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