Pulse wave velocity to the global longitudinal strain ratio in survivors of myocardial infarction

Eur J Clin Invest. 2019 Aug;49(8):e13131. doi: 10.1111/eci.13131. Epub 2019 Jun 6.

Abstract

Background: New index of pulse wave velocity to global longitudinal peak systolic strain (PWV/GLPSS) was reported to be associated with cardiovascular damage. We evaluated the prognostic role of this metric in survivors of acute myocardial infarction (AMI).

Material and methods: We investigated in 569 patients with AMI, whether PWV/GLPSS was associated with a composite endpoint of death, stroke or new myocardial infarction, in long-term follow-up. Left ventricular longitudinal strain was evaluated by speckle tracking, and carotid arterial stiffness (local PWV) was determined using radiofrequency data technology.

Results: During follow-up (median 1316 days), 114 subjects reached composite endpoint. These subjects were significantly older (P < 0.0001) and were characterized by lower ejection fraction (P < 0.0001), lower GLPSS (P < 0.0001), higher PWV (P = 0.007) and lower PWV/GLPSS index (P < 0.0001). Patients with PWV/GLPSS <-0.74 were at a significantly higher risk for the composite endpoint during the follow-up (hazard rate: 1.7; 95% confidence interval: 1.2-2.6; P < 0.001). The PWV/GLPSS was additive to the predictive value of EF < 35%-patients with PWV/GLPSS <-0.74 and EF < 35% had the highest risk for the endpoint events.

Conclusions: The current study shows that PWV/GLPSS index has significant, independent and additive value in predicting CV complications, in subjects with myocardial infarction.

Keywords: global longitudinal strain; myocardial infarction; pulse wave velocity.

MeSH terms

  • Aged
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Pulse Wave Analysis*
  • Survivors
  • Vascular Stiffness / physiology