Global and regional left ventricular strain indices in post-myocardial infarction patients with ventricular arrhythmias and moderately abnormal ejection fraction

We aimed to compare myocardial strains in ischemic heart patients with and without sustained ventricular tachycardia (VT) and moderately abnormal LVEF in order to investigate which index could better predict VT on the basis of the analysis of global and regional LV dysfunction. We studied 467 patients with previous myocardial infarction and LVEF > 35%. Fifty-one patients had documented VT and 416 patients presented with no VT. LV volumes and score index were obtained by two-dimensional echocardiography. Longitudinal, radial and circumferential strain were determined. Strains of infarct, border and remote zones were also obtained. There were no differences in standard LV two-dimensional parameters between patients with or without VT. ROC values were -12.7% for global longitudinal strain (AUC 0.72), -4.8% for posterior-inferior wall circumferential strain (AUC 0.80), 61ms for left ventricular mechanical dispersion (AUC 0.84), -10.1% for longitudinal strain of border zone (AUC 0.86), and -9.2% for circumferential strain of border zone (AUC 0.89). In patients with previous myocardial infarction and moderately abnormal LVEF, peri-infarct circumferential strain was the strongest predictor of documented ventricular arrhythmias among all strain quantitative indices. Additionally, strain values from posterior-inferior wall infarctions had a higher association with arrhythmic events compared to global strain.