The role of novel echocardiographic indices in the identification of myocardial injury in patients with NSTEMI

Abstract Funding Acknowledgements Type of funding sources: None. Introduction / Purpose Early detection of myocardial injury in patients with myocardial infarction presenting without persistent ST elevation (NSTEMI) is crucial for prognosis estimation. The purpose of this study is the assessment of novel echocardiographic indices in the detection of myocardial injury in patients with NSTEMI and normal left ventricular ejection fraction (LVEF). Methods In this case-control study, patients with NSTEMI (18 to 80 years old) who were examined at the echocardiography laboratory of our general hospital, from May 2021 until August 2022, and controls were enrolled. All patients had no former history of cardiac disease or other significant comorbidities, and they all had LVEF ≥55% and normal wall motion score index. After coronography all of them were diagnosed with significant coronary artery disease. Among the novel echocardiographic indices, global longitudinal strain (GLS), and the parameters of myocardial work, global work index (GWI), global constructive work (GCW), global wasted work (GWW) και global work efficiency (GWE) were examined. Τ - test was used to compare the means of the variables, since the distributions were normal, and a p value <0.05 was considered statistically significant. Results The participants of the study were 34 patients with NSTEMI (26 males), of mean age 60.1 years (SD 10.5 years) and 25 healthy volunteers (19 males), of mean age 52.5 years (SD 7.5 years). For the patients, mean |GLS| was 17.9% (SD 2.2), GWI 1957.7mmHg% (SD 368.2), GCW 2231.0mmHg% (SD 380.5), GWW 141.7mmHg% (SD 79.4) and GWE 92.2% (SD 3.8) (Table 1). As for the volunteers mean |GLS| was 20,6% (SD 2.2), GWI 2179.4mmHg% (SD 407.4), GCW 2409.9mmHg% (SD 406.1), GWW 93.2mmHg% (SD 64.4) and GWE 95.5% (SD 2.7). Patients with NSTEMI showed significantly lower values of GLS (p<0.01), GWI (p = 0.033) and GWE (p = 0.01) compared to healthy volunteers (Diagrams). Also, their GWW values were higher (p = 0.015) compared to volunteers. No statistically significant difference was found in the GCW values. Conclusion Novel echocardiographic indices were able to identify myocardial injury, even in patients presenting with NSTEMI and normal LVEF.