Abstract：
BACKGROUND: This study evaluates the relationship between global longitudinal strain (GLS) and late major adverse cardiovascular events (MACEs) in patients after acute myocardial infarction (AMI).
METHODS: Data of newly diagnosed AMI patients between March 2010 and July 2014 were retrospectively evaluated. The patients underwent serial echocardiography at admission and at third and sixth months post-admission. We calculated GLS by averaging the strain from all myocardial segments using speckle-tracking echocardiography (STE). We used multivariate Cox regression analysis and receiver operating characteristic (ROC) curve analyses to assess the relationship between GLS at admission and late MACEs.
RESULTS: Eighty-nine newly diagnosed AMI patients were enrolled. The average age at diagnosis was 61 ± 12.5 years, and approximately 89.9% of the patients were men. The average level of GLS was -17.5 ± 3.9%. The overall prevalence of MACEs was 23.6% (21/89), compared with 44% (11/25) in the group with GLS≥-15% and 17.9% (5/28) in the group with GLS<-20%. GLS was positively linked with MACEs in the fully adjusted Cox proportional hazard model (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.04-1.37; P=0.014) after adjusting potential confounders. The ROC curve analysis for one year MACEs between GLS at admission, with the most significant area under the curve(AUC) 78.1% (95% CI, 63.8% - 92.6%).
CONCLUSIONS: Myocardial dysfunction, characterized by impaired GLS, is often observed in AMI patients, and a decrease in GLS levels at admission were associated with an increased risk of long-term MACEs in post-myocardial infarction patients.
METHODS: Data of newly diagnosed AMI patients between March 2010 and July 2014 were retrospectively evaluated. The patients underwent serial echocardiography at admission and at third and sixth months post-admission. We calculated GLS by averaging the strain from all myocardial segments using speckle-tracking echocardiography (STE). We used multivariate Cox regression analysis and receiver operating characteristic (ROC) curve analyses to assess the relationship between GLS at admission and late MACEs.
RESULTS: Eighty-nine newly diagnosed AMI patients were enrolled. The average age at diagnosis was 61 ± 12.5 years, and approximately 89.9% of the patients were men. The average level of GLS was -17.5 ± 3.9%. The overall prevalence of MACEs was 23.6% (21/89), compared with 44% (11/25) in the group with GLS≥-15% and 17.9% (5/28) in the group with GLS<-20%. GLS was positively linked with MACEs in the fully adjusted Cox proportional hazard model (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.04-1.37; P=0.014) after adjusting potential confounders. The ROC curve analysis for one year MACEs between GLS at admission, with the most significant area under the curve(AUC) 78.1% (95% CI, 63.8% - 92.6%).
CONCLUSIONS: Myocardial dysfunction, characterized by impaired GLS, is often observed in AMI patients, and a decrease in GLS levels at admission were associated with an increased risk of long-term MACEs in post-myocardial infarction patients.
摘要：
背景：这项研究评估了急性心肌梗死（AMI）后患者的整体纵向应变（GLS）与晚期主要不良心血管事件（MACEs）之间的关系。
方法：对2010年3月至2014年7月的新诊断AMI患者资料进行回顾性分析。患者在入院时以及入院后第3个月和第6个月进行了连续超声心动图检查。我们通过使用斑点追踪超声心动图（STE）平均所有心肌节段的应变来计算GLS。我们使用多变量Cox回归分析和受试者工作特征（ROC）曲线分析来评估入院时GLS与晚期MACE之间的关系。
结果：纳入89例新诊断AMI患者。诊断时的平均年龄为61±12.5岁，约89.9%的患者为男性。GLS的平均水平为-17.5±3.9%。MACEs的总体患病率为23.6%(21/89)，与GLS≥-15%组的44%(11/25)和GLS<-20%组的17.9%(5/28)相比。在完全调整的Cox比例风险模型中，GLS与MACE呈正相关(风险比[HR]，1.19；95%置信区间[CI]，1.04-1.37；P=0.014）调整潜在混杂因素后。入院时GLS之间一年MACEs的ROC曲线分析，最显著的曲线下面积(AUC)为78.1%(95%CI,63.8%-92.6%)。
结论：心肌功能障碍，以受损的GLS为特征，经常在AMI患者中观察到，入院时GLS水平下降与心肌梗死后患者长期MACE风险增加相关.
方法：对2010年3月至2014年7月的新诊断AMI患者资料进行回顾性分析。患者在入院时以及入院后第3个月和第6个月进行了连续超声心动图检查。我们通过使用斑点追踪超声心动图（STE）平均所有心肌节段的应变来计算GLS。我们使用多变量Cox回归分析和受试者工作特征（ROC）曲线分析来评估入院时GLS与晚期MACE之间的关系。
结果：纳入89例新诊断AMI患者。诊断时的平均年龄为61±12.5岁，约89.9%的患者为男性。GLS的平均水平为-17.5±3.9%。MACEs的总体患病率为23.6%(21/89)，与GLS≥-15%组的44%(11/25)和GLS<-20%组的17.9%(5/28)相比。在完全调整的Cox比例风险模型中，GLS与MACE呈正相关(风险比[HR]，1.19；95%置信区间[CI]，1.04-1.37；P=0.014）调整潜在混杂因素后。入院时GLS之间一年MACEs的ROC曲线分析，最显著的曲线下面积(AUC)为78.1%(95%CI,63.8%-92.6%)。
结论：心肌功能障碍，以受损的GLS为特征，经常在AMI患者中观察到，入院时GLS水平下降与心肌梗死后患者长期MACE风险增加相关.
