Comprehensive strain assessment and mortality after acute myocardial infarction: a retrospective observational study based on the Essen Coronary Artery Disease registry
Authors' conclusion
The comprehensive evaluation of contractility of various cardiac chambers via transthoracic echocardiography using myocardial strain analysis, when routinely performed after acute myocardial infarction, may help to detect patients at increased mortality risk.
Study context
- Population
- Patients with NSTEMI or STEMI receiving echocardiography within 1 year after revascularisation157 (11.1%) died
- Participants
- 1,409 patients
- Exposure
- LV-GLS, RV-GLS and left atrial (LA) reservoir strain for prediction of mortality
- Outcome
- All-cause mortality
- Follow-up
- Median 1.5 (0.5-4.2) years
Methodological detailsregistry-based (Essen Coronary Artery Disease registry)
- Registry-based (Essen Coronary Artery Disease registry)
Main finding
As reported in the abstract
Mortality, per 1 SD increase in strain (multivariable Cox) · median 1.5 years
Hazard ratio (95% CI)P value
LV-GLS
1.68(1.37–2.06)
P < 0.001RV-GLS
1.39(1.16–1.67)
P < 0.001LA reservoir strain
0.57(0.47–0.69)
P < 0.001Per 1 SD, as printed
Observational data: associations, not effects.
Further findings
Mortality, strain measures further adjusted for LVEF, tricuspid annular plane systolic excursion (TAPSE) or LA volume index
| HR (95% CI) | P value | ||
|---|---|---|---|
| LV strain | 1.41 (1.06–1.89) | P = 0.02 | |
| RV strain | 1.48 (1.03–2.13) | P = 0.04 | |
| LA strain | 0.61 (0.49–0.76) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Prediction of mortality (ROC AUC)
- AUC, risk factors
- 0.67 (0.63-0.71)
- AUC, risk factors + three strain measures
- 0.75 (0.70-0.80)
- AUC, further addition of LVEF, TAPSE and LA volume index (no improvement)
- 0.75 (0.70-0.81)
Original publication
Comprehensive strain assessment and mortality after acute myocardial infarction: a retrospective observational study based on the Essen Coronary Artery Disease registry. Heart. Published 20 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →