A30 - Risk Stratification-based Left Ventricular Global Longitudinal Strain is a Better Predictor of Early Outcome in Patients with Cardiogenic Shock Complicating Acute MI

Register or Login to View PDF Permissions
Permissions× For commercial reprint enquiries please contact Springer Healthcare:

For permissions and non-commercial reprint enquiries, please visit to start a request.

For author reprints, please email
Information image
Average (ratings)
No ratings
Your rating



Published online:

Support:The development of this supplement was funded by Abiomed.

Correspondence Details:Surenjav Chimed,

Open Access:

The copyright in this work belongs to Radcliffe Medical Media. Only articles clearly marked with the CC BY-NC logo are published with the Creative Commons by Attribution Licence. The CC BY-NC option was not available for Radcliffe journals before 1 January 2019. Articles marked ‘Open Access’ but not marked ‘CC BY-NC’ are made freely accessible at the time of publication but are subject to standard copyright law regarding reproduction and distribution. Permission is required for reuse of this content.

Background: Cardiogenic shock (CS) remains the leading cause of death in acute MI (AMI), and precise risk stratification is crucial for the subsequent immediate management of CS. However, effective early risk-stratification tools for patients with CS are lacking.

Hypothesis: In this study, we hypothesised that risk stratification based on left ventricular (LV) global longitudinal strain (GLS) is a better predictor of early outcome in patients with CS complicating AMI.

Methods: The LV GLS was estimated by a speckle-tracking-derived algorithm. The 30-day mortality was chosen for the indicator of early outcome after primary percutaneous coronary intervention in patients with CS complicating AMI. The possible predictors of outcome were chosen from demographic, clinical, cardiac enzyme, angiographic and echocardiographic measurements by univariable hazard regression. Independent relationships of possible predictors were confirmed by multivariable hazard regression.

Results: A total of 51 patients with CS complicating AMI were selected (mean age 64 ± 14 years, 76% men). The 30-day mortality was 27.5% (n=14). LV GLS was significantly impaired in patients who died compared with survivors (−8.4 ± 3.9% versus −13.1 ± 4.4%, p<0.001). The QRS time (HR 1.02, 95% CI [1.00–1.04], p<0.05), peak troponin level (HR 1.01, 95% CI [1.00–1.01], p<0.01), estimated glomerular filtration rate (HR 0.97, 95% CI [0.95–0.99], p<0.01), E/e’ ratio (HR 1.06, 95% CI [1.02–1.09], p<0.001) and LV GLS (HR 1.19, 95% CI [1.07–1.33], p<0.001) were possible predictors of early outcome by univariable hazard regression. After adjustment for the above-mentioned variables, LV GLS was the only variable which was found to be an independent predictor of early outcome (HR 1.22, 95% CI [1.07–1.40], p=0.004). Furthermore, LV GLS showed good predictive capacity in receiver-operating characteristic curve analysis (area under the curve 0.79, cut-off value −10.8%, 95% CI [0.66–0.92], p<0.01). Kaplan–Meier estimation showed that patients with good LV recovery (LV GLS <−10.8%) had improved survival (log-rank p=0.006).

Conclusion: The risk stratification based on LV GLS is a better predictor of early outcome in patients with CS complicating AMI.