GIÁ TRỊ CỦA SIÊU ÂM TIM ĐÁNH DẤU MÔ 2D TRONG TIÊN LƯỢNG NGẮN HẠN Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP CÓ PHÂN SUẤT TỐNG MÁU THẤT TRÁI GIẢM

Abstract

Objective: To assess the value of global longitudinal strain (GLS) measured by 2D echocardiography in predicting major adverse cardiac events (MACE) and mortality in patients with acute coronary syndrome (ACS) and reduced left ventricular ejection fraction (LVEF). Subjects and Methods: This prospective, cross-sectional study included 116 ACS patients treated at the Cardiology Department of Cho Ray Hospital from November 2022 to April  2023. 2D echocardiography with GLS measurement was performed before discharge. Patients were followed up for cardiac events, including all-cause mortality, recurrent myocardial infarction, stroke, and heart failure readmission. Results: The average age was 70 ± 11.22 years, and 60.34% were male. Killip class 22 was present in 63.0% of patients. Fifty percent of patients experienced MACE, and 30 patients died during the study period. GLS predicted MACE with an area under the curve (AUC) of 0.74 (95% CI: 0.68 -0.85). At a GLS cutoff of 2-9.4%, MACE was identified with a sensitivity of 85% and specificity of 55%. In multivariate Cox analysis, only GLS independently predicted MACE with a hazard ratio (HR) of 1.18 (95% CI: 1.05 - 1.32, p = 0.004). GLS predicted mortality with an AUC of 0.73 (95% CI: 0.62 - 0.83) at a GLS cutoff of ≥ -9.4%, identifying mortality with a sensitivity of 89% and specificity of 75%. In multivariate Cox analysis, GLS was the only independent prognostic factor for mortality with an HR of 1.24 (95% CI: 1.05 - 1.47, p = 0.01). Conclusion: GLS by 2D speckle tracking echocardiography strongly and independently predicted MACE and short-term mortality inpatient with acute myocardial infarction and reduced left ventricular ejection fraction