Mohamed Ismail, Ramez Guindi, Sameh Atteya, Inas Eweda
The Impact of Coronary Flow Grade after Primary PCI on Global Longitudinal Left Ventricular Strain as Measured by Speckle Tracking Compared to Two-Dimensional Echo
Aim: Identify the impact of coronary flow on GLPS after primary percutaneous coronary intervention (PCI). Background: Left ventricular global longitudinal peak systolic strain (GLPS) was previously demonstrated to be related to outcome after acute myocardial infarction, however its relation to myocardial epicardial flow and microvascular flow were not studied before. Methods: We compared the left ventricular function in 75 consecutive patients admitted to coronary care unit with first acute ST segment elevation myocardial infarction (STEMI) using: speckle tracking derived GLPS and two dimensional echo. Then we assessed the relation between GLPS and myocardial flow. Results: Mean global longitudinal left ventricular strain was -13.26 ± 2.97% in TIMI flow 3 group of patients compared to -11.807 ± 1.08% in Thrombolysis in myocardial infarction (TIMI II) group. (p-value=0.01876). With longitudinal strain improved as better coronary flow was established as determined by TIMI myocardial perfusion (TMP) grades. There was no statistically significant difference between ejection fraction percent and segmental wall motion score index in patients with TIMI II or TIMI III flow. Conclusion: GLPS can detect early and minor changes in longitudinal LV function due to ischemia in absence of any appreciable abnormalities recognized on two dimensional echocardiographic examination. In addition the degree of change of GLPS is strongly correlated to the degree of epicardial and microvascular flow
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