الفهرس 
Adverse ventricular remodeling after myocardial infarctionOnly 14 pages are availabe for public view
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Abstract
BACKGROUND: Adverse left ventricular remodeling (LVR) begins in
some patients with acute myocardial infarction (AMI) even after successful
percutaneous coronary intervention (PCI). LVR comprises progressive
ventricular dilatation, distortion of chamber shape, myocardial hypertrophy,
and deteriorating function, which if uninterrupted leads to congestive heart
failure (CHF) and a poor clinical outcome. AIMS: This study aims at
evaluating the value of speckle tracking echocardiography in predicting
LVR after successful PCI in AMI patients. MATERIALS AND
METHODS: eighty-four acute myocardial infarction patients (group I) and
twenty-seven stable ischemic heart disease patients (group II) were
included. A thorough physical examination, ECG and a complete
echocardiographic assessment, including speckle tracking study, was
performed two days after PCI and then a follow up echocardiography with
speckle tracking study was done two months afterwards. Patients of group I
were then divided into two subgroups based on the presence of remodeling
(I R+, I R-). RESULTS: at baseline study global longitudinal strain (-
11.14±0.5 VS -16.78±0.4, P˂0.0001), longitudinal strain rate (-1.01±0.05
VS -1.07±0.04, P˂0.0001), culprit longitudinal strain (-9.74±0.59 VS -
15.68±0.49, P˂0.0001), culprit longitudinal strain rate (-0.95±0.05 VS -
1.02±0.04, P˂0.0001) were all lower in subgroup I R+ than in I R-. In the
follow up study all of the strain parameters studied were significantly lower
in the I R+ subgroup than I R-. The most sensitive and specific parameters
were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively)
and (specificities of 95% and 96.7% respectively). CONCLUSION: Our
findings show that impaired indices LV deformation detected two days after
successful PCI for AMI may provide predictive value in detecting LV
remodeling.
Keywords: Left ventricular remodeling, acute myocardial infarction,
speckle tracking echocardiography.