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Value of three-dimensional strain parameters for predicting left ventricular remodeling after ST-elevation myocardial infarction

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Abstract

This study was to evaluate the value of multi-directional strain parameters derived from three-dimensional (3D) speckle tracking echocardiography (STE) for predicting left ventricular (LV) remodeling after ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) compared with that of two-dimensional (2D) global longitudinal strain (GLS). A total of 110 patients (mean age, 54 ± 9 years) after STEMI treated with primary PCI were enrolled in our study. At baseline (within 24 h after PCI), standard 2D echocardiography, 2D STE and 3D STE were performed to acquire the conventional echocardiographic parameters and strain parameters. At 3-month follow-up, standard 2D echocardiography was repeated to all the patients to determine LV remodeling, which was defined as a 20% increase in LV end-diastolic volume. At 3-month follow-up, LV remodeling occurred in 26 patients (24%). Compared with patients without LV remodeling, patients with remodeling had significantly reduced 2D GLS (−12.5 ± 3.2% vs −15.0 ± 3.1%, p < 0.001), 3D GLS (−9.9 ± 2.2% vs −13.1 ± 2.7%, p < 0.001), 3D global area strain (GAS) (−20.3 ± 3.9% vs −23.3 ± 4.8%, p = 0.005) and 3D global radial strain (GRS) (29.0 ± 7.4% vs 34.3 ± 8.5%, p = 0.007) at baseline, but there is no significant difference in 3D global circumferential strain (GCS) (−12.7 ± 2.9% vs −13.0 ± 3.2%, p = 0.822). Separated multivariate analysis shows that 2D GLS, 3D GLS, 3D GAS and 3D GRS all can be independent predictors of LV remodeling. However, receiver-operating characteristic curve analysis showed that the area under the curve of 3D GLS (0.82) for predicting LV remodeling was significantly higher than that of 2D GLS (0.72, p = 0.034), 3D GAS (0.68, p < 0.001) and 3D GRS (0.68, p < 0.001). In patients after STEMI, 2D GLS, 3D GLS, 3D GAS and 3D GRS but not 3D GCS measured after primary PCI are independent predictors of LV remodeling and 3D GLS is the most powerful predictor among them.

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Acknowledgements

This study was supported in part by the Science and Technology Planning Project of Guangdong Province (2013A022100036, 2014A020212257), the Shenzhen Innovation Funding (SGLH20150213143207911, JCYJ20151030151431727), and the National Key Research and Development Program of China (2016YFC1300302, 2016YFC1301702). We gratefully acknowledge the volunteers who participated in our study.

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Authors and Affiliations

  1. Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA, Guangzhou, 510010, China

    Lin Xu, Xiaomin Huang, Jun Ma, Jiangming Huang, Yongwang Fan, Huidi Li & Jian Qiu

  2. Guangzhou University of Chinese Medicine, Guangzhou, 510403, China

    Xiaomin Huang

  3. Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Shenzhen, 518055, China

    Heye Zhang

  4. Southern Medical University, Guangzhou, 510515, China

    Wenhua Huang

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  1. Lin Xu
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  2. Xiaomin Huang
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Correspondence to Jian Qiu or Heye Zhang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lin Xu and Xiaomin Huang have contributed equally to this work.

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Xu, L., Huang, X., Ma, J. et al. Value of three-dimensional strain parameters for predicting left ventricular remodeling after ST-elevation myocardial infarction. Int J Cardiovasc Imaging 33, 663–673 (2017). https://doi.org/10.1007/s10554-016-1053-3

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