Prognosis after acute coronary syndrome in relation with ventricular-arterial coupling and left ventricular strain.

Abstract Background The value of modern non-invasive indices of the left ventricle (LV) and arterial system function, and their interaction for determining prognosis in contemporarily treated patients with acute coronary syndrome (ACS) is not well established. The study aimed to determine the association of ventricular–arterial (VA) coupling, LV global longitudinal peak systolic strain (GLPSS), global strain rate (GSR) and end-diastolic volume at end-diastolic pressure 30mmHg (V30) with long-term clinical outcomes in patients with ACS. Methods Echocardiography was applied in 569 ACS patients followed up for >12months after hospitalization. Univariate Cox proportional hazard regression models adjusted to various clinical factors, including reduced LV ejection fraction Results There were 57 clinical outcomes during a median follow-up of 625days. Increased VA coupling >1.68 (HR 2.4; 95% CI: 1.04–5.6); V30>107mL (HR 4.5; 95% CI: 1.9–10.6), GLPSS > −12.8% (HR 2.4; 95% CI: 1.02–5.7), GSR > −0.96 1/s (HR 3.8; 95% CI: 1.6–9.1) were robustly associated with increased hazard. Conclusions With a sample of contemporarily treated ACS patients, abnormal values of non-invasive indices of LV function and their interaction with arterial system, predict adverse clinical outcomes, independently of LV ejection fraction.