Document Type : Original Article
Authors
1
Professor of Cardiology Faculty of Medicine- Banha University enha university
2
Professor of Cardiology Faculty of Medicine - Banha University
3
Assistant Professor of Cardiovascular Medicine, Benha Teaching Hospital, Benha University
4
MBBCH Resident of cardiology GOTHI
5
Lecturer of Cardiology Faculty of Medicine- Banha University
Abstract
Background: Left ventricular remodeling (LVR) after acute STEMI significantly affects long-term outcomes, even in patients initially presenting with preserved EF. Early detection of those at risk for adverse remodeling and heart failure is critical. Speckle-tracking echocardiography (STE) identifies myocardial deformation prior to EF reduction. This study evaluated LVR using STE in STEMI patients with preserved EF treated by primary PCI. Methods: Fifty STEMI patients with preserved EF following PCI underwent clinical and echocardiographic assessment at baseline and six months. Results: The reduced EF group (<50%) showed significantly lower LVEF, LVEDV, LVESV, and ILS (P < 0.05). No significant differences were found in SVI, WMSI, E/A ratio, GLS, GLSR, GCS, GCSR, GRS, GRSR, ILSR, or infarct-related segment count. At six months, LVEF, SVI, GLSR, and GCS were significantly decreased, while LVESV and WMSI were increased in the <50% group (P = 0.009 and < 0.001, respectively). Univariate logistic regression identified age, smoking, hypertension, hyperlipidemia, Killip class, NT-proBNP, ILS, and ILSR as associated factors. Conclusion: Patients developing reduced EF at six months had higher Killip class and worse clinical outcomes, including LVR, HF, MI, hospitalization, and MACCE. STE-derived ILS and ILSR are promising early predictors of remodeling post-PCI and may enhance risk stratification in preserved EF STEMI populations.
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