Non-ST-segment elevation myocardial infarction (NSTEMI) accounts for 60-70% of all myocardial infarctions, making it a prevalent clinical condition. When left ventricular (LV) pressure rises during early systole, the myocardium may stretch, especially in regions experiencing ischemia and reduced contractile force. This study aimed to evaluate the relationship between early systolic lengthening (ESL) and high-risk angiographic territory involvement in NSTEMI patients.
Conducted on 96 patients with NSTEMI and an LV ejection fraction of 50% or greater who underwent coronary angiography (CAG), the research classified participants into two groups based on their angiographic findings—those with high-risk territory involvement and those without. Each patient underwent transthoracic echocardiography on the first day of hospitalization, allowing for the measurement of ESL, the duration of ESL (DESL), left ventricular global longitudinal strain (LVGLS), and various diastolic and systolic velocities using Doppler techniques.
The results indicated that patients with high-risk angiographic territory involvement exhibited longer DESL, DESLLAD, and DESLLCX compared to those without (p-values of 0.016, 0.044, and 0.04, respectively). Logistic regression analysis revealed that only age and early systolic lengthening of the left anterior descending artery (ESLLAD) were independently associated with high-risk territory involvement, with significant p-values and odds ratios indicating their predictive value.
In conclusion, evaluating myocardial ESL by speckle-tracking echocardiography could serve as a valuable tool in predicting high-risk angiographic territories in NSTEMI patients. A higher ESL value may indicate a greater risk, potentially guiding clinical decisions towards an early invasive strategy rather than a conservative approach to treatment.
