Comparison of global left ventricular myocardial work indices at baseline and after 3 months of st-segment elevation myocardial infarction

• Published in: European heart journal Vol. 41; no. Supplement_2
• Main Authors: De Paula Lustosa, R, Van Der Bijl, P, Goedemans, L, El Mahdiui, M, Montero-Cabezas, J.M, Kostyukevich, M, Ajmone Marsan, N, Bax, J.J, Delgado, V
• Format: Journal Article
• Language: English
• Published: 01.11.2020
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/ehjci/ehaa946.0111

Abstract Background Global left ventricular myocardial work indices (GLVMWI) are derived from speckle tracking echocardiographic strain data in combination with non-invasive blood pressure recordings. Global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) are derived from these measures. GLVMWI in ST-segment elevation myocardial infarction (STEMI) remains unexplored and comparison between measures of GLVMWI at index event (baseline) and follow-up is unknown. Purpose To assess the evolution in GLVMWI in STEMI patients from baseline (index infarct) to 3 months' follow-up. Methods This retrospective study included 350 patients (265 men, mean age: 61±10 years) with STEMI treated with primary percutaneous coronary intervention and optimal, guideline-based medical therapy. Clinical variables, echocardiographic measures and GLVMWI were recorded at baseline and 3 months follow-up. Results Left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), GWI, GCW and GWE improved significantly at 3 months follow-up with no significant difference in GWW (Table). These findings suggest that the impaired values of GLVMWI at baseline are related to stunning after STEMI and they recover at 3 months follow-up without further deterioration in GWW, which probably reflects irreversible myocardial damage. Conclusions In STEMI patients treated with primary percutaneous coronary intervention and optimal guideline-based medical therapy, GLVMWI assessed by speckle tracking strain echocardiography are significantly improved at 3 months follow-up, without significant changes in GWW. GLVMWI therefore have the potential to identify reversible and irreversible components of post-infarct myocardial damage. Funding Acknowledgement Type of funding source: Other. Main funding source(s): European Society of Cardiology Research Grant