Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot Study

(1) Background: Left ventricular ejection fraction (LVEF) is traditionally used to assess prognosis in acute ST-elevation myocardial infarction (STEMI) patients. However, LV myocardial work (MW), evaluated echocardiographically, offers additional prognostic information by considering loading conditi...

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Main Authors: Alexandra-Cătălina Frișan, Mihai-Andrei Lazăr, Raluca Șoșdean, Marius Simonescu, Daniel-Miron Brie, Aniko Mornoș, Silvia Ana Luca, Ioana Ionac, Cristian Mornoș
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Language:English
Published: MDPI AG 2025-02-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/3/338
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author Alexandra-Cătălina Frișan
Mihai-Andrei Lazăr
Raluca Șoșdean
Marius Simonescu
Daniel-Miron Brie
Aniko Mornoș
Silvia Ana Luca
Ioana Ionac
Cristian Mornoș
author_facet Alexandra-Cătălina Frișan
Mihai-Andrei Lazăr
Raluca Șoșdean
Marius Simonescu
Daniel-Miron Brie
Aniko Mornoș
Silvia Ana Luca
Ioana Ionac
Cristian Mornoș
author_sort Alexandra-Cătălina Frișan
collection DOAJ
description (1) Background: Left ventricular ejection fraction (LVEF) is traditionally used to assess prognosis in acute ST-elevation myocardial infarction (STEMI) patients. However, LV myocardial work (MW), evaluated echocardiographically, offers additional prognostic information by considering loading conditions. (2) Methods: This prospective study investigated the prognostic value of MW indices in 119 consecutive STEMI patients treated with primary percutaneous coronary angioplasty, stratified into three LVEF categories: reduced (≤40%), mildly reduced (41–49%), and preserved LVEF (≥50%). Transthoracic echocardiography was performed before discharge, and the primary endpoint included heart failure hospitalization, ventricular arrhythmias, all-cause mortality and new acute coronary syndromes. (3) Results: Patients with preserved or mildly reduced LVEF had higher global longitudinal strain, global work index, global constructive work (GCW), and global work efficiency, as well as lower global wasted work (GWW), compared to those with reduced LVEF. GCW was the strongest predictor of adverse outcomes in the preserved LVEF group (AUC = 0.730, <i>p</i> = 0.035), while GWW demonstrated robust predictive performance in the reduced LVEF group (AUC = 0.787, <i>p</i> = 0.001). (4) Conclusions: MW indices, particularly GCW and GWW, provide significant prognostic value in distinct LVEF categories in STEMI patients. These findings indicate that MW enhances risk stratification and informs management in this patient population.
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spelling doaj-art-162ed72b73154ebd98f004d1f8550adf2025-08-20T01:48:57ZengMDPI AGLife2075-17292025-02-0115333810.3390/life15030338Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot StudyAlexandra-Cătălina Frișan0Mihai-Andrei Lazăr1Raluca Șoșdean2Marius Simonescu3Daniel-Miron Brie4Aniko Mornoș5Silvia Ana Luca6Ioana Ionac7Cristian Mornoș8Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, RomaniaCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, RomaniaCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, RomaniaCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, RomaniaInstitute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, RomaniaInstitute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, RomaniaCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, RomaniaCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, RomaniaCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania(1) Background: Left ventricular ejection fraction (LVEF) is traditionally used to assess prognosis in acute ST-elevation myocardial infarction (STEMI) patients. However, LV myocardial work (MW), evaluated echocardiographically, offers additional prognostic information by considering loading conditions. (2) Methods: This prospective study investigated the prognostic value of MW indices in 119 consecutive STEMI patients treated with primary percutaneous coronary angioplasty, stratified into three LVEF categories: reduced (≤40%), mildly reduced (41–49%), and preserved LVEF (≥50%). Transthoracic echocardiography was performed before discharge, and the primary endpoint included heart failure hospitalization, ventricular arrhythmias, all-cause mortality and new acute coronary syndromes. (3) Results: Patients with preserved or mildly reduced LVEF had higher global longitudinal strain, global work index, global constructive work (GCW), and global work efficiency, as well as lower global wasted work (GWW), compared to those with reduced LVEF. GCW was the strongest predictor of adverse outcomes in the preserved LVEF group (AUC = 0.730, <i>p</i> = 0.035), while GWW demonstrated robust predictive performance in the reduced LVEF group (AUC = 0.787, <i>p</i> = 0.001). (4) Conclusions: MW indices, particularly GCW and GWW, provide significant prognostic value in distinct LVEF categories in STEMI patients. These findings indicate that MW enhances risk stratification and informs management in this patient population.https://www.mdpi.com/2075-1729/15/3/338myocardial workspeckle tracking echocardiographyglobal longitudinal strainST-elevation myocardial infarctionadverse outcomesleft ventricular ejection fraction
spellingShingle Alexandra-Cătălina Frișan
Mihai-Andrei Lazăr
Raluca Șoșdean
Marius Simonescu
Daniel-Miron Brie
Aniko Mornoș
Silvia Ana Luca
Ioana Ionac
Cristian Mornoș
Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot Study
Life
myocardial work
speckle tracking echocardiography
global longitudinal strain
ST-elevation myocardial infarction
adverse outcomes
left ventricular ejection fraction
title Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot Study
title_full Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot Study
title_fullStr Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot Study
title_full_unstemmed Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot Study
title_short Myocardial Work Analysis in ST-Elevation Myocardial Infarction: Insights into Left Ventricular Ejection Fraction—A Pilot Study
title_sort myocardial work analysis in st elevation myocardial infarction insights into left ventricular ejection fraction a pilot study
topic myocardial work
speckle tracking echocardiography
global longitudinal strain
ST-elevation myocardial infarction
adverse outcomes
left ventricular ejection fraction
url https://www.mdpi.com/2075-1729/15/3/338
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