Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction

  • Inge Noringriis
  • Daniel Modin
  • Sune H. Pedersen
  • Jan S. Jensen
  • Tor Biering-Sørensen
Original Paper


The aim of this study is to assess the prognostic value of mechanical dyssynchrony defined as the standard deviation of the time to peak longitudinal strain (SD T2P LS) in predicting the development of heart failure (HF) after an ST-segment elevation myocardial infarction (STEMI). Three hundred and seventy-three patients were admitted with STEMI and treated with primary percutaneous coronary intervention. Left ventricular (LV) mechanical dyssynchrony was examined through speckle tracking echocardiography and defined as SD T2P LS. The association with the outcome of HF hospitalization was assessed using Cox proportional hazard models. During a median follow-up of 5.12 years, 144 patients (38.6%) were admitted due to HF. Worse dyssynchrony was associated with the outcome in unadjusted and multivariable analysis (multivariable hazard ratio 1.05, 95% confidence interval 1.00–1.10, p-value 0.039, per 10 ms increase), but not after further adjustment for LV ejection fraction (LVEF), E/e′ and global longitudinal strain (GLS) (hazard ratio 1.01, 95% confidence interval 1.00–1.07, p-value 0.71, per 10 ms increase), nor in a model only adjusting for GLS (hazard ratio 1.01, 95% confidence interval 1.00–1.06, p-value 0.61, per 10 ms increase). These findings were reproduced in a competing risk analysis treating all-cause mortality as a competing risk. LV mechanical dyssynchrony, as assessed by SD T2P LS is not an independent predictor of post-STEMI HF development and mechanical dyssynchrony does not provide independent prognostic information regarding HF when GLS is known.


Dyssynchrony Speckle tracking ST elevation myocardial infarction Heart failure 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10554_2018_1443_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 22 KB)


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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Department of Cardiology, Herlev & Gentofte HospitalUniversity of CopenhagenCopenhagenDenmark

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