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Presence of post-systolic shortening is an independent predictor of heart failure in patients following ST-segment elevation myocardial infarction

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  2. Left ventricular end-diastolic pressure is associated with left atrial functional measures by echocardiography

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  3. Usefulness of echocardiography for predicting ventricular tachycardia detected by implantable loop recorder in syncope patients

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  1. Frequency of Electrocardiographic Alterations and Pericardial Effusion in Patients With Uncomplicated Malaria

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  2. Changes in left atrial structure and function over a decade in the general population

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  3. Left atrial strain predicts incident atrial fibrillation in the general population: the Copenhagen City Heart Study

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  4. Normal values and reference ranges for left atrial strain by speckle-tracking echocardiography: the Copenhagen City Heart Study

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Following an ischemic event post systolic shortening (PSS) may occur. We investigated the association between PSS in patients with ST-segment elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI) and occurrence of cardiovascular events at follow-up. A total of 373 patients admitted with STEMI and treated with pPCI were prospectively included in the study cohort. All patients were examined by echocardiography a median of 2 days after admission (interquartile range, 1-3 days). PSS was measured by color tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) in six myocardial walls from all three apical projections. During a median follow-up period of 5.4 years (interquartile range, 4.1-6.0 years), 180 events occurred: 59 deaths, 70 heart failures (HF) and 51 new myocardial infarctions (MI). In multivariable analysis adjusting for: age, sex, peak troponin, left ventricle ejection fraction, TIMI flow grade, left ventricle mass index, hypertension and diabetes, presence of PSS by TDI in the culprit region was associated with a nearly twofold increased risk of HF (HR 1.90, 95% CI 1.02-3.53, P = 0.043) and the risk of HF increased incrementally with increasing numbers of walls displaying PSS. The increased risk of HF was confirmed when assessing the post-systolic index by STE (HR 1.29 95% CI 1.09-1.53, P = 0.003, per 1% increase). A regional analysis showed that PSS by TDI in the septal wall was the strongest predictor of HF (HR 1.77, 95% CI 1.08-2.92, P = 0.024). Presence of PSS was not associated with increased risk of death or MI. In patients with STEMI treated with pPCI, the presence of PSS examined by TDI and STE provides prognostic information on development of HF. Presence of PSS in the septal wall is the strongest predictor of HF.

Original languageEnglish
JournalThe international journal of cardiovascular imaging
Volume34
Issue number5
Pages (from-to)751-760
Number of pages10
ISSN1569-5794
DOIs
Publication statusPublished - May 2018

    Research areas

  • Journal Article

ID: 53702736