RESEARCH ARTICLE
Regional Longitudinal Myocardial Deformation Provides Incremental Prognostic Information in Patients with STSegment Elevation Myocardial Infarction Tor Biering-Sørensen1,2*, Jan Skov Jensen1,2, Sune H. Pedersen1, Søren Galatius1, Thomas Fritz-Hansen1, Jan Bech1, Flemming Javier Olsen1, Rasmus Mogelvang1
a11111
1 Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark, 2 Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark * [email protected]
OPEN ACCESS Citation: Biering-Sørensen T, Jensen JS, Pedersen SH, Galatius S, Fritz-Hansen T, Bech J, et al. (2016) Regional Longitudinal Myocardial Deformation Provides Incremental Prognostic Information in Patients with ST-Segment Elevation Myocardial Infarction. PLoS ONE 11(6): e0158280. doi:10.1371/ journal.pone.0158280 Editor: Wolfgang Rudolf Bauer, University Hospital of Würzburg, GERMANY Received: March 30, 2016 Accepted: June 13, 2016 Published: June 27, 2016 Copyright: © 2016 Biering-Sørensen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Since the data for the present report is obtained from human patients and therefore governed by the Danish Data Protection Agency, a separate approval has to be obtained for any additional researcher to gain access to the anonymized data. Therefore, the authors cannot provide the data for this patient study unless anyone interested applies for approval from the Danish Data Protection Agency. Funding: This study was financially supported by the Faculty of Health Sciences, University of
Abstract Background Global longitudinal systolic strain (GLS) has recently been demonstrated to be a superior prognosticator to conventional echocardiographic measures in patients after myocardial infarction (MI). The aim of this study was to evaluate the prognostic value of regional longitudinal myocardial deformation in comparison to GLS, conventional echocardiography and clinical information.
Method In total 391 patients were admitted with ST-Segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention and subsequently examined by echocardiography. All patients were examined by tissue Doppler imaging (TDI) and two-dimensional strain echocardiography (2DSE).
Results During a median-follow-up of 5.3 (IQR 2.5–6.1) years the primary endpoint (death, heart failure or a new MI) was reached by 145 (38.9%) patients. After adjustment for significant confounders (including conventional echocardiographic parameters) and culprit lesion, reduced longitudinal performance in the anterior septal and inferior myocardial regions (but not GLS) remained independent predictors of the combined outcome. Furthermore, inferior myocardial longitudinal deformation provided incremental prognostic information to clinical and conventional echocardiographic information (Harrell's c-statistics: 0.63 vs. 0.67, p = 0.032). In addition, impaired longitudinal deformation outside the culprit lesion perfusion region was significantly associated with an adverse outcome (p
Regional Longitudinal Myocardial Deformation Provides Incremental Prognostic Information in Patients with STSegment Elevation Myocardial Infarction Tor Biering-Sørensen1,2*, Jan Skov Jensen1,2, Sune H. Pedersen1, Søren Galatius1, Thomas Fritz-Hansen1, Jan Bech1, Flemming Javier Olsen1, Rasmus Mogelvang1
a11111
1 Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark, 2 Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark * [email protected]
OPEN ACCESS Citation: Biering-Sørensen T, Jensen JS, Pedersen SH, Galatius S, Fritz-Hansen T, Bech J, et al. (2016) Regional Longitudinal Myocardial Deformation Provides Incremental Prognostic Information in Patients with ST-Segment Elevation Myocardial Infarction. PLoS ONE 11(6): e0158280. doi:10.1371/ journal.pone.0158280 Editor: Wolfgang Rudolf Bauer, University Hospital of Würzburg, GERMANY Received: March 30, 2016 Accepted: June 13, 2016 Published: June 27, 2016 Copyright: © 2016 Biering-Sørensen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Since the data for the present report is obtained from human patients and therefore governed by the Danish Data Protection Agency, a separate approval has to be obtained for any additional researcher to gain access to the anonymized data. Therefore, the authors cannot provide the data for this patient study unless anyone interested applies for approval from the Danish Data Protection Agency. Funding: This study was financially supported by the Faculty of Health Sciences, University of
Abstract Background Global longitudinal systolic strain (GLS) has recently been demonstrated to be a superior prognosticator to conventional echocardiographic measures in patients after myocardial infarction (MI). The aim of this study was to evaluate the prognostic value of regional longitudinal myocardial deformation in comparison to GLS, conventional echocardiography and clinical information.
Method In total 391 patients were admitted with ST-Segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention and subsequently examined by echocardiography. All patients were examined by tissue Doppler imaging (TDI) and two-dimensional strain echocardiography (2DSE).
Results During a median-follow-up of 5.3 (IQR 2.5–6.1) years the primary endpoint (death, heart failure or a new MI) was reached by 145 (38.9%) patients. After adjustment for significant confounders (including conventional echocardiographic parameters) and culprit lesion, reduced longitudinal performance in the anterior septal and inferior myocardial regions (but not GLS) remained independent predictors of the combined outcome. Furthermore, inferior myocardial longitudinal deformation provided incremental prognostic information to clinical and conventional echocardiographic information (Harrell's c-statistics: 0.63 vs. 0.67, p = 0.032). In addition, impaired longitudinal deformation outside the culprit lesion perfusion region was significantly associated with an adverse outcome (p
