Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Heart failure (HF) is a feared complication of myocardial infarction (MI). It contributes to a poor prognosis and has a high morbidity. In patients with heart failure, it’s important to track progress and identify signs of heart failure as early as possible. Speckle-tracking strain imaging (STSI) is a novel echocardiographic technique that has emerged as a valuable technique for identifying myocardial dysfunction and predicting the progression of heart failure. This is done by measuring the amount the myocardium deforms in relation to the original length during contraction and relaxation. This is done by measuring the natural acoustic “speckles” in the myocardial tissue on ultrasound images. The movement of these speckles allows for the measurement of myocardial shortening and lengthening which can be displayed through graphs. Beyond global measures like GLS there are also applications for STSI such as regional strain abnormalities and mechanical dyssynchrony. These are independent predictors of HF outcomes in post-MI patients.
Methods: A systematic review was conducted using PubMed, ScienceDirect, and Cochrane to identify studies published between 2000 and 2024. Keywords included “speckle-tracking strain imaging,” “myocardial infarction,” and “heart failure.” This yielded 214 articles and exclusion criteria were established to remove review articles to focus on primary research, which reduced the search to 23 articles. We focused on studies that concerned STSI parameters and how they are associated with HF outcomes. The data on diagnostic accuracy and patient outcomes was then synthesized.
Results: When compared to the left ventricular ejection fraction GLS was shown to be superior. GLS values below -15% were correlated with adverse outcomes such as left ventricular remodeling, heart failure, and mortality. In patients with ST-elevation myocardial infarctions a GLS cut off of -10.85 predicted left ventricular remodeling with a sensitivity of 89.7% and a specificity of 91.7%. Regional strain abnormalities were caught with STSI even when myocardial segments had normal wall motion. These abnormalities significantly predicted mortality (HR = 1.42, 95% CI = 1.06-1.90, P = .02). Post-systolic strain also predicted heart failure in acute coronary syndrome in patients with percutaneous coronary intervention. (HR = 1.61, 95% CI = 1.21-2.12, P = .001) Mechanical Dyssynchrony was associated with increased mortality and HF in post-MI patients (HR = 1.16, 95% CI = 1.06-1.27, P = .001). However, when adjusted for confounders there wasn’t a significant prognostic utility in heart failure with preserved ejection fraction (HFpEF). Levosimendan therapy was found to improve myocardial contraction when measuring peak systolic velocity from 4.70 cm/s ± 1.34 to 6.07 cm/s ± 1.47 (P < 0.001) and GLS (P = 0.007) compared to placebo. Additionally, AV-synchronous pacing also resulted in a median increase of 16.9% in stroke volume. Benefits were most obvious in post-MI patients.
Conclusions: STSI offers robust predictive and diagnostic capabilities and surpasses traditional echocardiographic measures. Its integration into routine clinical practice can enhance risk stratification. Future research should focus on standardizing strain thresholds and exploring its role in multimodal imaging strategies.
Recommended Citation
Shaju, Ronald A.; Sepulveda, Alyssa L.; Gutierrez, Yolanda V.; and Cruz, Melissa M., "Predictive Value of Speckle-Tracking Strain Imaging in Risk Stratification of Post-Myocardial Infarction Heart Failure" (2025). Research Symposium. 139.
https://scholarworks.utrgv.edu/somrs/2025/posters/139
Included in
Predictive Value of Speckle-Tracking Strain Imaging in Risk Stratification of Post-Myocardial Infarction Heart Failure
Background: Heart failure (HF) is a feared complication of myocardial infarction (MI). It contributes to a poor prognosis and has a high morbidity. In patients with heart failure, it’s important to track progress and identify signs of heart failure as early as possible. Speckle-tracking strain imaging (STSI) is a novel echocardiographic technique that has emerged as a valuable technique for identifying myocardial dysfunction and predicting the progression of heart failure. This is done by measuring the amount the myocardium deforms in relation to the original length during contraction and relaxation. This is done by measuring the natural acoustic “speckles” in the myocardial tissue on ultrasound images. The movement of these speckles allows for the measurement of myocardial shortening and lengthening which can be displayed through graphs. Beyond global measures like GLS there are also applications for STSI such as regional strain abnormalities and mechanical dyssynchrony. These are independent predictors of HF outcomes in post-MI patients.
Methods: A systematic review was conducted using PubMed, ScienceDirect, and Cochrane to identify studies published between 2000 and 2024. Keywords included “speckle-tracking strain imaging,” “myocardial infarction,” and “heart failure.” This yielded 214 articles and exclusion criteria were established to remove review articles to focus on primary research, which reduced the search to 23 articles. We focused on studies that concerned STSI parameters and how they are associated with HF outcomes. The data on diagnostic accuracy and patient outcomes was then synthesized.
Results: When compared to the left ventricular ejection fraction GLS was shown to be superior. GLS values below -15% were correlated with adverse outcomes such as left ventricular remodeling, heart failure, and mortality. In patients with ST-elevation myocardial infarctions a GLS cut off of -10.85 predicted left ventricular remodeling with a sensitivity of 89.7% and a specificity of 91.7%. Regional strain abnormalities were caught with STSI even when myocardial segments had normal wall motion. These abnormalities significantly predicted mortality (HR = 1.42, 95% CI = 1.06-1.90, P = .02). Post-systolic strain also predicted heart failure in acute coronary syndrome in patients with percutaneous coronary intervention. (HR = 1.61, 95% CI = 1.21-2.12, P = .001) Mechanical Dyssynchrony was associated with increased mortality and HF in post-MI patients (HR = 1.16, 95% CI = 1.06-1.27, P = .001). However, when adjusted for confounders there wasn’t a significant prognostic utility in heart failure with preserved ejection fraction (HFpEF). Levosimendan therapy was found to improve myocardial contraction when measuring peak systolic velocity from 4.70 cm/s ± 1.34 to 6.07 cm/s ± 1.47 (P < 0.001) and GLS (P = 0.007) compared to placebo. Additionally, AV-synchronous pacing also resulted in a median increase of 16.9% in stroke volume. Benefits were most obvious in post-MI patients.
Conclusions: STSI offers robust predictive and diagnostic capabilities and surpasses traditional echocardiographic measures. Its integration into routine clinical practice can enhance risk stratification. Future research should focus on standardizing strain thresholds and exploring its role in multimodal imaging strategies.
