Effect of Global Longitudinal Strain at Discharge Period on Predicting Cardiac Defibrillator Implantation in STEMİ Patients with Impaired Left Ventricle Systolic Functions.

Abstract

Background and Objectives: Contemporary studies have shown that low ejection fraction (EF) is a significant predictor of sudden cardiac death in ischemic heart failure. However, relying solely on EF and waiting 90 days for ICD implantation is inadequate for preventing sudden death in STEMI patients. Materials and Methods: This study aims to explore if left ventricular global longitudinal strain (GLS) measured at discharge can predict EF < 35% at the third-month follow-up in STEMI patients with impaired systolic function (EF < 35%). The study involved 69 patients diagnosed with STEMI. The results from 29 patients with EF ≤ 35% and 40 patients with EF between 36 and 49% were compared. Echocardiographic images were recorded, and the LV GLS value was measured. Results: In both univariate and multivariate regression analyses, LV GLS at discharge was the only independent predictor of EF ≤ 35% after three months. An LV GLS value below 9.55% at discharge predicted an EF below 35% at 90 days, with 75% sensitivity and 76.5% specificity (AUC = 0.814, p = 0.005). Conclusions: Current guidelines recommend waiting three months before ICD implantation in STEMI patients with EF ≤ 35%, but this study suggests that low GLS can help identify high-risk patients earlier, potentially reducing the waiting period for ICD implantation.