Myocardial Work for Prediction of Left Ventricular Remodeling in Patients With STEMI

Study Overview
=================
Brief Summary
-----------------
The study intends to investigate the alteration of regional myocardial work in patients with acute anterior myocardial infarction underwent primary percutaneous coronary intervention (PCI), and compare the distribution of regional myocardial work in patients with/without early remodeling at acute phase and 3-month follow-up.

Official Title
-----------------
Value of Myocardial Work for Prediction of Left Ventricular Remodeling in Patients With ST-Elevation Myocardial Infarction Treated by Primary Percutaneous Intervention

Conditions
-----------------
ST-Segment Elevated Myocardial Infarction

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Anterior myocardial infarct (anterior myocardial infarct is defined as persistent chest pain for 30 mins at least, with ST-segment elevation of at least 0.2 mV in two or more contiguous precordial leads) within 12 hours after onsets of symptom; Left anterior descending (LAD) as culprit vessel, with TIMI 0-1 grade. Exclusion Criteria: significant valvular disease; cardiomyopathy; l left bundle branch block; atrial fibrillation; previous myocardial infarction (MI); history of cardiac surgery; pacemaker implantation.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients with LVR(left ventricular remodeling)<br> | |
| patients without LVR(left ventricular remodeling)<br> | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delta-work efficiency by echocardiography | A novel tool for non-invasive myocardial work(MW) assessment has been introduced to evaluate myocardial performance.MW was calculated as a function of time through a combination of LV global longitudinal strain(GLS) data and an estimated LV pressure curves. Work efficiency (WE) was calculated from the ratio of the constructive work to the sum of constructive and wasted work, expressed as a percentage.The values of culprit regional WE was expressed as WE-LAD.The values of non-culprit regional WE was expressed as WE-nonLAD.The absolute differences of the WE was calculated as the values of non-culprit regional WE minus the values of culprit regional WE, and noted as delta-WE. | 24-72 hours after PCI | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Global work index by echocardiography | Global work index (GWI) is classified as total work within the area of the LV pressure-strain loop calculated from mitral valve closure to mitral valve opening. | 24-72 hours, 3-month after PCI | 
| Global constructive work by echocardiography | Global constructive work (GCW) was defined as work contributing to LV ejection performed during shortening in systole and work performed during lengthening in isovolumic relaxation. | 24-72 hours, 3-month after PCI | 
| Global work efficiency by echocardiography | Global work efficiency (GWE) was calculated from the ratio of the constructive work to the sum of constructive and wasted work, expressed as a percentage. | 24-72 hours, 3-month after PCI | 
| Work index-LAD | Work index in left anterior descending(LAD) territory. | 24-72 hours, 3-month after PCI | 
| Constructive work-LAD | constructive work in left anterior descending(LAD) territory. | 24-72 hours, 3-month after PCI | 
| Work efficiency-LAD | Work efficiency in left anterior descending(LAD) territory. | 24-72 hours, 3-month after PCI | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
ST-segment elevated myocardial infarction, myocardial work, left ventricular remodeling