Usefulness of non-invasive myocardial work to predict left ventricular recovery and acute complications after acute anterior myocardial infarction treated by primary percutaneous intervention

Predicting left ventricular (LV) recovery after acute ST-elevation myocardial infarction (STEMI) is challenging and of prognostic importance. Objective To evaluate the usefulness of non-invasive myocardial work (MW), a new index of global and regional myocardial performance, to predict LV recovery and in-hospital complications after STEMI. Methods In total, 93 consecutive patients with anterior STEMI (mean age, 59 ± 12 years) treated by primary percutaneous intervention (PCI) underwent transthoracic echocardiography (TTE) within 24–48 hours after angioplasty and a median of 92 days at follow-up. MW is derived from the non-invasive strain-pressure loop obtained from the 2D strain data, integrating in its calculation the non-invasive brachial arterial pressure. Segmental LV recovery was defined as a normalization of segmental wall motion abnormalities of the affected segments and global recovery as an absolute improvement of left ventricular ejection fraction (LVEF) greater than 5% in patients with baseline LVEF  Results In total, 1642 segments were studied and MW was impaired in infarct segments, more severely in no recovering versus recovering segments (MW index, constructive MW, MW efficiency, all, P  Conclusion In patients with anterior STEMI treated by PCI, acute constructive MW is an independent predictor of segmental and global LV recovery, as well as in-hospital complications.