Evaluation of LV Remodeling and Predictors of Heart Failure in Cases with Acute ST Elevation Myocardial Infarction with Preserved Left Ventricular Systolic Function after Successful Primary PCI

Ebaid, Hany H.; Al-rabbat, Khaled E.; Maklad, Wael A.; Hasan, Abdel Kareem G.; ELSAYED, Amr A.

doi:10.21608/bmfj.2025.386552.2422

	Evaluation of LV Remodeling and Predictors of Heart Failure in Cases with Acute ST Elevation Myocardial Infarction with Preserved Left Ventricular Systolic Function after Successful Primary PCI
Benha Medical Journal
Volume 42, Issue 8, August 2025, Page 69-79 PDF (798.43 K)
Document Type: Original Article
DOI: 10.21608/bmfj.2025.386552.2422
View on SCiNiTO
Authors
Hany H. Ebaid ¹; Khaled E. Al-rabbat²; Wael A. Maklad³; Abdel Kareem G. Hasan ⁴; Amr A. ELSAYED⁵
¹Professor of Cardiology Faculty of Medicine- Banha University enha university
²Professor of Cardiology Faculty of Medicine - Banha University
³Assistant Professor of Cardiovascular Medicine, Benha Teaching Hospital, Benha University
⁴MBBCH Resident of cardiology GOTHI
⁵Lecturer 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.
Keywords
STEMI; Left ventricular remodeling; Speckle-tracking echocardiography; PCI; ejection fraction


Statistics Article View: 55 PDF Download: 44