GIÁ TRỊ TIÊN LƯỢNG CỦA SỨC CĂNG DỌC TOÀN BỘ THẤT TRÁI VÀ SỰ BIẾN ĐỔI THEO THỜI GIAN TRONG DỰ BÁO BIẾN CỐ TIM MẠCH CHÍNH Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP

Abstract

Objectives: To evaluate the prognostic value of left ventricular global longitudinal strain (LVGLS) and its temporal change (ΔLVGLS) in predicting major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI). Methods: A prospective, longitudinal study was conducted on 120 AMI patients who underwent percutaneous coronary intervention PCI. LVGLS was measured using speckle-tracking echocardiography at baseline (within 24 hours of admission) and at 7 days, 1, 3, 6, 9, and 12 months after PCI. MACE were recorded during a 12-month follow-up period. Results: Baseline LVGLS was significantly lower in the group with MACE than in the group without MACE (-10 ± 2.9% vs. -12.6 ± 3.3%; p = 0.001). LVGLS had better predictive value for MACE (AUC = 0.721; p = 0.001) than left ventricular ejection fraction (LVEF) (AUC = 0.674; p = 0.011). The optimal cut-off value ​​for LVGLS was -11.4%; patients with LVGLS ≥ -11.4% were at higher risk for MACE (p = 0.007). Interestingly, both baseline LVGLS (HR 1.23, 95%CI: 1.00 - 1.50; p = 0.046) and a > 22% reduction in ΔLVGLS (HR 8.46, 95%CI: 1.11 - 64.2; p = 0.039) were independent predictors of MACE in patients with AMI. Conclusion: LVGLS and ΔLVGLS are independent prognostic indicators in patients with AMI. Notably, LVGLS is a better predictor of MACE than LVEF.