Correlation between global left ventricular myocardial work efficiency and prognosis within 1 year follow up in patients after ST-segment–elevation myocardial infarction

Abstract

Global left ventricular (LV) myocardial work efficiency (GLVMWE); the ratio of constructive to wasted work in all LV segments, reflects the efficiency by which mechanical energy is expended during the cardiac cycle. Global LV myocardial work efficiency (GLVMWE) can be derived from LV pressure-strain loop analysis incorporating both noninvasively estimated blood pressure recordings and echocardiographic strain data. Aim: To assess the correlation between the global left ventricular myocardial work efficiency and prognosis within 1 year follow up in patients after ST-Segment–Elevation myocardial infarction (STEMI). Methods: This prospective cohort study was conducted at Cardiology Department of International medical center (IMC), Cairo, Egypt and Benha university hospitals on 100 patients presented with STEMI within 48-hours from hospital admission during the period from February 2022 to July 2023. All patients were subjected to full history taking, full clinical examination, ECG, routine laboratory investigations including CBC, ALT and bilirubin, Serum creatinine, Lipid profile, Peak of High sensitive cardiac Troponin I (Hs-cTnI) within 24 hours and GRACE (Global Registry of Acute Coronary Events) Score assessment. GLVMWE was measured. Patients were divided into preserved and reduced global work efficiency (GWE) groups. Results: GRACE score was higher, the anterior STEMI was more frequent, patients came later and the LAD coronary artery was the most frequently involved culprit vessel in reduced GWE than preserved GWE. EF, GLS and GWE at baseline & after 1 year follow up were lower in reduced GWE group with (P=0.001). Statistical analysis showed significant difference between the preserved and reduced GWE groups regarding MACE data which occurred more frequent in reduced GWE with (P=0.017). ROC curve was done for GWE data at baseline for prediction of developing MACE during follow up period. A cutoff value below 87% at baseline had an increased incidence for developing MACE during one year follow up period with 62% sensitivity, 92% specificity and AUC 0.878 (P<0.0001) Conclusion: Reduced GLVMWE measured with transthoracic echocardiography within 48 hours of admission is associated with worse prognosis and long-term adverse MACE in STEMI patients.

Imprint

Hany Hassan Ahmed Ebaid, Khaled Ahmed Emad Eldin El Rabat, Ibrahim Mohammed Attia Abdelfattah, Amr Abd Elmordy Elsayed Ali. Correlation between global left ventricular myocardial work efficiency and prognosis within 1 year follow up in patients after ST-segment–elevation myocardial infarction. Cardiometry; Issue 30; February 2024; p.27-35; DOI: 10.18137/cardiometry.2024.30.2735; Available from: https://www.cardiometry.net/issues/no30-february-2024/correlation-between-global-left-ventricular