Author + information
- Received September 11, 2014
- Revision received October 2, 2014
- Accepted October 8, 2014
- Published online February 1, 2015.
- Soo Jin Park, MD∗,
- Jae-Hyeong Park, MD, PhD∗∗ (, )
- Hyeon Seok Lee, MD∗,
- Min Su Kim, MD∗,
- Yong Kyu Park, MD∗,
- Yunseon Park, ARDCS∗,
- Yeon Ju Kim, ARDCS∗,
- Jae-Hwan Lee, MD, PhD∗,
- Si-Wan Choi, MD, PhD∗,
- Jin-Ok Jeong, MD, PhD∗,
- In Sun Kwon, PhD† and
- In-Whan Seong, MD, PhD∗
- ∗Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, South Korea
- †Clinical Trial Center, Chungnam National University Hospital, Daejeon, South Korea
- ↵∗Reprint requests and correspondence:
Dr. Jae-Hyeong Park, Department of Cardiology, Internal Medicine, Chungnam National University, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, South Korea.
Objectives The aim of this study was to assess the long-term prognostic value of the global longitudinal strain of the right ventricle (GLSRV) in patients with inferior ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).
Background RV systolic dysfunction is an important prognostic factor in patients with inferior STEMI.
Methods All consecutive inferior STEMI patients were included from January 2005 to December 2013. RV systolic function was analyzed with GLSRV using velocity vector imaging (Siemens, Mountain View, California), as well as conventional echocardiographic indices, including right ventricular fractional area change (RVFAC) and tricuspid annular plane systolic excursion (TAPSE).
Results We analyzed a total of 282 consecutive inferior STEMI patients (212 men, age 63 ± 13 years) treated with primary PCI. During the follow-up period (54 ± 35 months), 59 patients (21%) had 1 or more major adverse cardiovascular event (MACE) (43 deaths, 7 nonfatal MI, 4 target vessel revascularization, and 6 heart failure admission). The best cutoff value of GLSRV for the prediction of MACE was ≥−15.5% (area under the curve = 0.742, p < 0.001) with a sensitivity of 73% and a specificity of 65%. GLSRV showed better sensitivity and specificity than RVFAC and TAPSE. After multivariate analysis, GLSRV showed a higher c-statistic value (0.770) than RVFAC (0.749) and TAPSE (0.751) in addition to age, Killip class, troponin-I, left ventricular (LV) ejection fraction and RV infarction. Patients with GLSRV≥−15.5% showed significantly lower 5-year survival rate (74 ± 5% vs. 89 ± 3%, p < 0.001) and lower MACE-free survival rate (64 ± 5% vs. 87 ± 3%, p < 0.001) than the control group.
Conclusions Because GLSRV showed additive predictive value to age and LV function, it can be the strongest parameter of RV systolic function evaluating the prognosis after PCI for acute inferior STEMI particularly in patients with preserved LV function.
- acute ST-segment elevation myocardial infarction
- right ventricular function
- strain echocardiography
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 11, 2014.
- Revision received October 2, 2014.
- Accepted October 8, 2014.
- American College of Cardiology Foundation