Value of 3-dimensional speckle tracking echocardiography in the
prediction of cardiovascular events in patients with hypertension
complicated by acute myocardial infarction: a long-term follow-up study
Abstract
Background Patients with hypertension complicated by acute myocardial
infarction (AMI) have a poor prognosis. Identification of powerful
predictors of recurring cardiovascular events (RCEs) is very important.
This study sought to evaluate the predictive value of three-dimensional
(3D) strain parameters for RCEs in patients with hypertension
complicated by AMI. Methods We successfully followed up 62 patients with
hypertension and AMI. Participants underwent three-dimensional
echocardiography before, one week after, and one month after
percutaneous coronary intervention (PCI). Left ventricular (LV)
structural function parameters and three-dimensional strain parameters
(3-dimensional global longitudinal strain (3D-GLS), 3-dimensional global
circumferential strain (3D-GCS), 3-dimensional global radial strain
(3D-GRS), and 3-dimensional global area strain (3D-GAS)) were acquired.
We used a Cox model to determine the relationships between these
parameters and RCEs. Results During follow-up (41.27±20.45 months), 20
patients (32.8%) had RCEs, which were independently predicted one month
after PCI by 3D-GLS (HR: 1.481, 95%CI: 1.202-1.824) and 3D-GAS (HR:
1.254, 95%CI: 1.093-1.440). The optimal 3D-GLS and 3D-GAS cutoffs for
predicting cardiac events were >-12.5% [area under the
receiver operating characteristic curve (AUC) 0.736, 95%CI 0.611-0.862,
P=0.003)] and >20.5% (AUC 0.685, 95%CI 0.551-0.818,
P=0.020), respectively. Using logistic regression analysis, we
constructed joint predictor=(3D-GLS)+(3D-GAS)×0.303/0.558, and its
cutoff point was -22.36% (AUC 0.829, 95%CI 0.722-0.937,
P<0.001). Conclusions 3D-GLS and 3D-GAS assessed one month
after PCI can predict RCEs in patients with hypertension complicated by
AMI. Additionally, the predicted value of (3D-GLS)+ (3D-GAS)×0.303/0.558
was higher than the predicted value of either parameter alone.