Relationship Between Time of Ischemia and Global Longitudinal Strain of Left Ventricle in Patients with ST-Segment Elevation Myocardial Infarction who were Successfully Reperfused
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Abstract
Background: Coronary heart disease (CHD) is a problem that contributes to morbidity and mortality. Acute myocardial infarction with ST-Segment Elevation Myocardial Infarction (STEMI) is the most common manifestation of CHD. Cardiac muscle damage caused by STEMI is dynamic. The longer coronary is occluded, the area of infarction will be greater than cause biomechanical changes in the myocardium. Speckle Tracking Echocardiography (STE) through a longitudinal strain parameter is a technique of assessing myocardial deformation and predicting the infarct area immediately after reperfusion therapy.
Method: This study was an analytic observational study with a cross-sectional method. Subjects were STEMI patients who were successfully reperfused and fulfilled the inclusion and exclusion criteria. Transthoracic echocardiography was performed within 12 hours after reperfusion. Strain analysis was done offline at the work station. A normality test was performed to determine the type of correlation test used. The influence of confounding factors was analyzed by bivariate and multivariate. A value of p <0.05 was said to be statistically significant.
Results: There were 43 subjects, ischemia time and global longitudinal starin (GLS) were obtained. A normality test using Shapiro Wilk revealed that data distribution of the two variables was abnormal. The Spearman correlation test was used to assess the relationship between the two variables and found a negative correlation between the time of ischemia and GLS (r = -0.546; p = 0.000). Bivariate and multivariate analyses were performed to assess the influence of confounding factors. From the multivariate test, it was found that ischemia time was an independent factor influencing GLS value (p = 0.002).
Conclusion: There is a negative correlation between ischemia time and left ventricular GLS in STEMI patients who were successfully reperfused (r = -0.546; p = 0.000).