Search

Objective To investigate the predictive value of three-dimensional speckle tracking echocardiography (3D-STE), myocardial work (MW), and late gadolinium enhancement cardiac magnetic resonance (CMR-LGE) in left ventricular remodeling (LVR) after acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 77 patients with STEMI who underwent primary percutaneous coronary intervention (PPCI) from August 2022 to August 2023 in Lianyungang First People's Hospital were enrolled. All patients underwent routine transthoracic echocardiography (TTE), 3D-STE, and MW within 24 hours after surgery. The left ventricular parameters including global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), global area strain (GAS), global work index (GWI), global effective work (GCW), global wasted work (GWW), and global work efficiency (GWE) were measured. CMR-LGE was performed within 7 days after surgery, and TTE, 3D-STE, and MW were repeated at 3 months after surgery. The increase left ventricular end-diastolic volume (LVEDV) ≥20% was defined as LVR after myocardial infarction. The predictive value of each index for LVR after myocardial infraction (MI) was analyzed. Results According to the LVR gold standard, there were 18 cases in the LVR group (23.4%) and 59 cases in the non-LVR group (76.6%). Compared with the non-LVR group, TTE-LVEF, GWI, GCW, GWE, GLS, GRS, GCS, GAS decreased, TTE-LVESV and GWW increased, infarct size (IS) increased and CMR-LVEF decreased in the LVR group. At 3 months follow up after PPCI, the LVR group had lower GWI, GCW, GWE, GLS, GRS, TTE-LVEF than the non-LVR group (P＜0.05). Multivariate logistic regression and ROC analysis showed that CMR-IS, GWI, GLS and GAS were independent predictors of LVR (P＜0.01), and their AUC were 0.815, 0.806, 0.775, 0.734, respectively. Conclusion 3D-STE and MW are helpful in predicting LVR after PPCI in STEMI patients, especially GLS and GWI, which are similar in value and not inferior to CMR-IS.