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, Pages 69-79 PDF (798.43 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/bmfj.2025.386552.2422 | ||
| Authors | ||
| Hany H. Ebaid1; 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 | ||
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