Myocardial deformation imaging in early prediction of heart failure development after STEMI is better than conventional echocardiography: true or false?

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf PREDICT-VT Heart failure (HF) still develops in 4% up to 28% STEMI pts treated by pPCI, with the highest incidence first year. Accurate and early identification high-risk patients would allow targeted personalized intensive treatment . Aim current study is a sub-study (NCT03263949). Its aim define multi-parametric model for HF prediction based on clinical data, conventional echocardiographic data from myocardial deformation analysis obtained speckle tracking echocardiography. Methods 307 consecutive enrolled PREDICT-VT, echocardiography (5 ± 2 days after pPCI) was done included LA multilayer LV longitudinal (L), radial (R) circumferential (C) strain (S; %) rate (SR, 1/sec). indices post systolic shortening (PSS LS) CS) strains were also calculated Results From 242 who completed 1-year follow-up, 9 % develop NYHA class 3 or 4, 27 remaining 64% I. Significant univariate predictors were: parameters - female gender (ß =0.156, p = 0.015; 95% CI -0.431 – 0.047), older age =0.130, 0.044; 0.000 0.017), Killip admission (ß=0.131, 0.043; 0.007 0.435) previous atrial fibrillation (ß=0.181, 0.005; 0.175 0.960); echo parameters- LVEF (ß=-0.302, < 0.001; -0.029 -0.012), LAVI (ß=0.134, 0.046; 95%CI 0.030), degree diastolic dysfunction (ß=0.297, 0.192 0.465) TAPSE (ß=-4.255, 0.001); peak epicardial LS (ß=0.293, 0.030 0.074), SRs (ß=0.274, 0.398 1.069) PSS (ß=0.336, 0.925 2.019); endocardial CS (ß=0.254, 0.013 0.041), SR E (ß= -0.247, -0.556 -0.173) (ß=0.206, 0.003; 0.302 1.473); left mechanics (ß=-0.231, -0.025 -0.007). Predictive power variables (Killip admission, gender, history fib) development significantly improved when ehocardiographic added (LVEF, TAPSE, function) (R2 0.076 0.197, 0.001). However, addition MDI (longitudinal cirumferential levels) increased it further 0.200 0.229, Conclusion above parameters, amount ventricular post-systolic directions, expressed as indexes shortening, pPCI.