PMID- 28334029
OWN - NLM
STAT- MEDLINE
DCOM- 20170822
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 3
DP  - 2017
TI  - Prognostic power of global 2D strain according to left ventricular ejection 
      fraction in patients with ST elevation myocardial infarction.
PG  - e0174160
LID - 10.1371/journal.pone.0174160 [doi]
LID - e0174160
AB  - BACKGROUNDS: We aimed to evaluate the predictive power of longitudinal and 
      circumferential fibers according to left ventricular ejection fraction (LVEF) in 
      successfully reperfused acute ST elevation myocardial infarction (STEMI) 
      patients. METHODS: Total 691 patients (age 59+/-13, 20% female) underwent clinical 
      evaluation and conventional and strain echocardiography (Global longitudinal 
      strain (GLS), global circumferential strain (GCS)). The clinical outcome was 
      defined as the composite of death, hospitalization for heart failure, non-fatal 
      myocardial infarction, and ventricular arrhythmia. RESULTS: During a follow-up of 
      39+/-19 months, there were 47 (6.8%) clinical events. In multivariate Cox models 
      adjusted clinical risk factors, age (HR 1.08, p = 0.001) and GLS (HR 1.37, p = 
      0.001) were independent predictors. The addition of GLS resulted in significant 
      incremental improvement in the predictive value on LVEF (chi2 = 31.8-->45.8, 
      p<0.001), although GCS offers no additional benefit. In the subgroup analysis 
      according to LVEF, adjusted with clinical factors, GLS was significant predictive 
      for outcome for the patients with mildly depressed (LVEF 40-50%, HR 2.25, 
      p<0.001) and significantly depressed (LVEF<40%, HR 1.28, p = 0.016) systolic 
      function, although GCS and LVEF lost their power with LVEF<40%. For the patients 
      with preserved LVEF (>50%), GLS, GCS and LVEF did not show significant predictive 
      power. CONCLUSIONS: GLS is a most powerful predictor of outcome in successfully 
      reperfused STEMI patients, especially with depressed LV dysfunction, although GCS 
      and LVEF lost their predictive power for the patients with significantly 
      depressed LV function. However, GLS did not predict outcome for the patients with 
      preserved LVEF (>50%).
FAU - Cha, Myung-Jin
AU  - Cha MJ
AD  - Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, 
      Seoul National University College of Medicine, Seoul National University 
      Hospital, Seoul, South Korea.
FAU - Kim, Hyun-Sook
AU  - Kim HS
AD  - Cardiovascular Division, Department of Internal Medicine, Hallym University 
      Medical Center, Anyang, South Korea.
FAU - Kim, Seong Hwan
AU  - Kim SH
AD  - Division of Cardiology, Department of Internal Medicine, Korea University Medical 
      Center, Anam, South Korea.
FAU - Park, Jae-Hyeong
AU  - Park JH
AD  - Cardiovascular Division, Department of Internal Medicine, Chungnam National 
      University Hospital, Daejeon, South Korea.
FAU - Cho, Goo-Yeong
AU  - Cho GY
AUID- ORCID: 0000-0002-7067-5535
AD  - Division of Cardiology, Cardiovascular Center, Seoul National University Bundang 
      Hospital, Seongnam, South Korea.
LA  - eng
PT  - Journal Article
DEP - 20170323
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
EIN - PLoS One. 2017 Oct 10;12 (10 ):e0186437. PMID: 29016660
MH  - Age Factors
MH  - Aged
MH  - Echocardiography/methods
MH  - Female
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/*diagnosis/mortality/physiopathology
MH  - Stroke Volume/*physiology
MH  - Ventricular Function, Left/*physiology
PMC - PMC5363861
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2017/03/24 06:00
MHDA- 2017/08/23 06:00
PMCR- 2017/03/23
CRDT- 2017/03/24 06:00
PHST- 2016/11/28 00:00 [received]
PHST- 2017/03/03 00:00 [accepted]
PHST- 2017/03/24 06:00 [entrez]
PHST- 2017/03/24 06:00 [pubmed]
PHST- 2017/08/23 06:00 [medline]
PHST- 2017/03/23 00:00 [pmc-release]
AID - PONE-D-16-47018 [pii]
AID - 10.1371/journal.pone.0174160 [doi]
PST - epublish
SO  - PLoS One. 2017 Mar 23;12(3):e0174160. doi: 10.1371/journal.pone.0174160. 
      eCollection 2017.