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The following is a summary of “Association between segmental noninvasive longitudinal strain and quantitative microvascular perfusion in ST-segment elevation myocardial infarction: implications for clinical outcomes,” published in the February 2025 issue of the BMC Cardiovascular Disorders by Zhang et al.

This study investigates the relationship between segmental longitudinal strain (LS) and quantitative microvascular perfusion (qMVP) in patients with ST-segment elevation myocardial infarction (STEMI), aiming to assess their prognostic significance following primary percutaneous coronary intervention (pPCI). A retrospective analysis was conducted on 61 patients who underwent pPCI for their first STEMI. Myocardial contrast echocardiography (MCE) was used to evaluate microvascular perfusion (MVP) qualitatively and qMVP quantitatively, while two-dimensional speckle tracking echocardiography (2D-STE) was employed to assess segmental LS. 

Myocardial wall perfusion was visually classified, and perfusion parameters were analyzed using an 18-segment model. The study examined correlations between segmental LS and qMVP and evaluated their prognostic value in predicting major adverse cardiac events (MACE). Among the 314 myocardial segments exhibiting abnormal wall motion, 44 demonstrated normal microvascular perfusion (nMVP), 87 had delayed microvascular perfusion (dMVP), and 183 showed microvascular obstruction (MVO). Segmental LS exhibited a significant correlation with both segmental wall motion and qMVP, suggesting its sensitivity to myocardial damage. At the 12-month follow-up, 19 patients experienced MACE, with NT-proBNP levels, regional LS (rLS), and regional qMVP (r-qMVP) showing significant associations with these events. The predictive performance of the combined rLS and r-qMVP indices, as reflected by the area under the curve (AUC), was superior to that of either parameter alone (P < 0.001). 

These findings indicate that segmental LS is closely linked to qMVP in infarcted myocardial segments following reperfused STEMI. Both rLS and r-qMVP serve as sensitive markers of myocardial injury and demonstrate prognostic value for adverse clinical outcomes. Furthermore, their combined assessment enhances predictive accuracy, underscoring the potential utility of incorporating both parameters in post-STEMI risk stratification. Future research should explore their integration into routine clinical practice to optimize long-term patient management and outcomes.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-025-04547-5