ABSTRACT
To determine whether left ventricular (LV) global longitudinal strain (GLS) predicts adverse LV remodeling and cardiac events. In a prospective cohort study of patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI), we recorded clinical data and GLS, global circumferential strain and radial strain using two-dimensional speckle-tracking echocardiography of the left ventricle. At 6-month and 3-year follow-ups, patients were grouped by presence or absence of adverse LV remodeling. We used logistic regression to identify factors associated with adverse LV remodeling and a Cox model to determine the relationships between these factors and cardiac events. Of 97 patients (mean age 56 ± 12 years; 76 men), 38 showed LV remodeling. Diabetes mellitus [odds ratio (OR) 1.95% confidence interval (CI) 1.2-4.8, p = 0.05], peak troponin I (OR 1.2, 95% CI 1.1-1.3, p = 0.004), and GLS (OR 1.6, 95% CI 1.3-2.3, p = 0.009) independently predicted LV remodeling. During follow-up (22.8 ± 12.3 months), 20 patients suffered adverse events, which were independently predicted by GLS alone (OR 4.9, 95% CI 1.7-13.9, p = 0.002). Optimal GLS cutoffs for predicting adverse LV remodeling and cardiac events were >-12.46% [area under receiver operating-characteristic curve (AUC) 0.88, 95% CI 0.79-0.96, p < 0.001] and >-9.27% (AUC 0.86, 95% CI 0.64-0.98, p < 0.001), respectively. GLS measured immediately after primary PCI is an excellent predictor of adverse LV remodeling and cardiac events in patients with AMI.
Subject(s)
Myocardial Infarction/therapy , Percutaneous Coronary Intervention/adverse effects , Systole , Ventricular Function, Left , Ventricular Remodeling , Adult , Aged , Chi-Square Distribution , Echocardiography, Doppler, Color , Echocardiography, Doppler, Pulsed , Female , Humans , Kaplan-Meier Estimate , Logistic Models , Male , Middle Aged , Multivariate Analysis , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/physiopathology , Odds Ratio , Predictive Value of Tests , Proportional Hazards Models , Prospective Studies , Risk Factors , Spain , Stress, Mechanical , Time Factors , Treatment OutcomeABSTRACT
The frequency of allels, intragenic (intron 18) and extrangenic (DXS52) Bcl I RFLPs was investigated in a sample of the Mexican population. Altogether 33 X chromosomes at R8c locus and 30 at DXS52 locus were studied. The allele frequencies found at the F8c locus were similar to those reported in the majority of other populations. The observed heterozygosity for the intragenic extragenic markers were 0.57 and 0.64, respectively. By using these two RFLps 15 famales at risk in five independent families with hemophilia A were investigated; ten for them could be identified and five excluded as carries
