Background: Left ventricular remodeling (LVr) following acute myocardial infarction (AMI) is a crucial precursor to heart failure development and a crucial predictor of death. The speckle tracking (STE) approach has several benefits over conventional echocardiography evaluation including angle-independent observations and the ability to discern between active and passive wall segment movement. This research aimed to evaluate the value of STE in the prediction of LVr and improvement of left ventricular function after primary percutaneous coronary intervention (pPCI) in patients with AMI. Methods: This prospective cohort study was carried out on 136 patients following pPCI. Echocardiography and STE were done on the day of admission, 1 day, one week, 3, and six months after pPCI. The primary outcome was the diagnostic accuracy of global longitudinal strain (GLS) to predict LVr. The secondary outcomes were a comparison between LVEF and GLS variables baseline and after pPCI at different follow-up intervals. Results: LVEF was significantly lower at, 3 months, and 6 months in patients with remodeling than patients without remodeling (P value <0.05) and was insignificantly different at baseline, 1 day and 1 week between both groups. GLS was significantly lower at 1 day, 1 week, 3 months, and 6 months compared to baseline in patients with remodeling and patients without remodeling. GLS can significantly early predict LVr (P < 0.001 and AUC = 0.780) at cut-off >-14 with 89.74% sensitivity, and 77.32% specificity while LVEF can’t early predict LVr (P=0.055 and AUC=0.599) at cut-off ≤ 50 with 46.15% sensitivity, and 60.82% specificity. Conclusions: The STE approach is preferable than echocardiography for objectively assessing of the early functional changes and early prediction of remodeling in patients with MI after pPCI.

Left Ventricular Remodelling, Speckle Tracking Echocardiography, Myocardial Infarction, PCI