The association of left ventricular end-diastolic pressure with global longitudinal strain and scintigraphic infarct size in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

Int J Cardiovasc Imaging. 2021 Jan;37(1):359-366. doi: 10.1007/s10554-020-01945-y. Epub 2020 Aug 6.

Abstract

Left ventricular end-diastolic pressure (LVEDP) is an independent predictor for prognosis in ST-elevation myocardial infarction (STEMI) patients. We aimed to investigate the relationship of admission LVEDP measured after a successful primary percutaneous coronary intervention (pPCI) with scintigraphic infarct size (IS) and global longitudinal strain (GLS), a strong predictor of IS, in STEMI patients. A total of 62 consecutive patients with STEMI were enrolled in the study. LVEDP measurements were performed after pPCI in patients who had TIMI-3 flow. Echocardiography was performed 24 h after pPCI and repeated 3 months later. GLS was calculated as an average peak strain from the 3 apical projections. IS was evaluated at the third month by technetium 99m sestamibi. The mean age was 56 ± 8 years in the study population. The mean LVEDP was found 19.4 ± 4.4 mmHg. Median IS was 4% (0-11.7 IQR).The mean GLS at the 24th hour and the third month were found to be - 15.4 ± 2.8 and - 16.7 ± 2.5 respectively. There was a moderate negative correlation between LVEDP and GLS (24th-hour p < 0.001 r = - 0.485 and third-month p < 0.001 r = - 0.489). LVEDP had a moderate positive correlation with scintigraphic IS (p < 0.001 r = 0.545). In the multivariable model, we found that LVEDP was significantly associated with scintigraphic IS (β coefficient = 0.570, p = 0.008) but was not associated with the 24th hour (β coefficient = 0.092, p = 0.171) and third month GLS (β coefficient = 0.037, p = 0.531). This study demonstrated that there was a statistically significant relationship between LVEDP and scintigraphic IS, and IS was increased with high LVEDP values. However, there was not a relationship between LVEDP and GLS.

Keywords: Acute myocardial infarction; Left ventricular end-diastolic pressure; Strain.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardium / pathology*
  • Percutaneous Coronary Intervention* / adverse effects
  • Predictive Value of Tests
  • Prospective Studies
  • Radiopharmaceuticals
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / pathology
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / therapy*
  • Technetium Tc 99m Sestamibi
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon*
  • Treatment Outcome
  • Ventricular Function, Left*
  • Ventricular Pressure*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi