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Two- Dimensional Speckle –Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients after Myocardial Infarction and Percutaneous Coronary Intervention

Naveen Jamwal, Assistant Professor, Department of Cardiology, DR RML Institute of Medical Sciences, Vibhuti khand, Gomtinagar, Lucknow, U.P., India 226010. , Tiwari Bhuwan C.* , Jamwal Naveen** , Misra Mukul*** , Vijay Sudarshan K.* , Jha Ashish** , Lohakare Akash****

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Journal of Cardiovascular Medicine and Surgery 3(2):p 89-94, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3217.2

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Abstract

Background: Left ventricular remodeling (LVR) is prognostically important consequence of Acute Myocardial Infarction (AMI). However, data regarding the role of STE based parameters for predicting LVR in patients after MI who undergo PCI have been lacking. Aims and Objectives: To evaluate the role of STE in the prediction of LVR in patients after PCI in AMI and the factors associated with LVR after successful PCI. Material and Methods: This is a prospective study conducted in a tertiary care hospital in patients with AMI. Patients were analyzed pre and post intervention PCI) using STE in 100 patients. Results: LVR was found in 39% of AMI patients. Among cases with successful reperfusion within 2 hours from symptom onset none had LVR, 18.75% cases with time to reperfusion 2hrs to one day had LVR, 32.65% of cases with time to reperfusion within 17 days had LVR and 64.52% of cases with time to reperfusion >7 days had LVR. There was a significant improvement in circumferential strain in different LV segments following PCI. LVEF and STE parameters LVGLS, LVGCS (basal and apical), regional LVLSR, regional LVCS at baseline and at one month were predictors of LVR. Conclusions: LVR was common in AMI patients even after successful PCI and was strongly associated with the time to reperfusion. The STE parameters of global longitudinal strain, regional longitudinal strain rate, basal and apical global and regional circumferential strain at baseline and 30 days after the PCI were predictors of LVR at 3 months post PCI.

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3217.2

Keywords

STE–Speckle Tracking Echocardiography; LVRLeft Ventricular Remodeling; LVGLSLeft Ventricular Global Longitudinal Strain; LVGCSLeft Ventricular Global Circumferential Strain; AMIAcute Myocardial Infarction; PCI Percutaneous Coronary Intervention. 

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