Dear Sir,
I have read with interest a study from Batra et al. that was published in 2022, volume 32, issue no 1, page 12–16, with title of left ventricular (LV) functional remodeling after primary percutaneous coronary intervention.[1] I am highlighting the use of usual echo parameters to measure remodeling in LV with good result.
I do agree with the reason why authors choose simple echocardiographic parameters (LV ejection fraction [LVEF], LV end-diastolic dimension, LV end-systolic dimension, and wall motion score index [WMSI]) for measuring LV functional remodeling in patient after primary percutaneous coronary intervention (PPCI). However, I think, authors should mention global longitudinal strain (GLS) is not very helpful to assess global LV systolic function in patients with ischemic cardiomyopathies since the impairment of the myocardium may be focal and distributed in homogeneously. In contrast, segmental longitudinal strain has demonstrated its diagnostic value in the location of hypocontractile segments of the culprit lesion in the acute phase of STEMI.[2] Assessment of infarct size by echocardiography after PCI in patients with STEMI was superior with GLS and WMSI when compared with LVEF.[3]
In our hospital, we seldom do GLS examination for PPCI patients except for research. Hopefully, study from Batra et al. can give us a good insight for using usual echo parameters to evaluate infarct size.
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REFERENCES
- 1.Batra MK, Malik MA, Khan KA, Rai L, Kumar R, Shah JA, et al. Left ventricular functional remodeling after primary percutaneous coronary intervention. J Cardiovasc Echogr. 2022;32:12–6. doi: 10.4103/jcecho.jcecho_64_21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Salazar-Marin S, Valencia JM, Hernandez-Vasquez OM, Estrada JM. Usefulness of two-dimensional longitudinal peak systolic strain in patients with a clinical diagnosis of non-ST elevation myocardial infarction. Rev Colomb Cardiol. 2017;24:550–8. [Google Scholar]
- 3.Ismail A, Samy W, Aly R, Fawzy S, Hussein K. Longitudinal strain in patients with STEMI using speckle tracking echocardiography. Correlation with peak infarction mass and ejection fraction. Egypt J Crit Care Med. 2015;3:45–53. [Google Scholar]
