Relationship of Fractional Shortening Value with Global Longitudinal Left Ventricular Strain in Acute Coronary Syndrome Patients at H Adam Malik Hospital Medan
Background
The management of post-acute coronary syndrome patients (SKA) has evolved beyond merely alleviating symptoms, with a focus on preventing the progression of left ventricular dysfunction. The residual function of the left ventricle has become a crucial indicator of a patient's prognosis. In this context, Global Longitudinal Strain (GLS) has emerged as a significant predictor of improving systolic function and the incidence of myocardial remodeling after SKA. However, not all echocardiographic devices are equipped with the modalities necessary to measure GLS. As a more common alternative, M-Mode can be used to assess Fractional Shortening (FS) more easily.
The Importance of Fractional Shortening in Acute Coronary Syndrome
Fractional Shortening (FS) is a widely used echocardiographic parameter that measures the percentage of left ventricular shortening during systole. It is a simple and non-invasive method that can provide valuable information about left ventricular function. In the context of acute coronary syndrome, FS has been shown to be a reliable predictor of left ventricular dysfunction and prognosis. The ability to measure FS using M-Mode echocardiography makes it an attractive alternative to more complex and expensive methods, such as GLS.
Methodology
This study aimed to analyze the correlation between the FS value obtained through M-Mode on the Parasternal Long Axis (PLAX) pieces in the left ventricle and the average GLS obtained using the Echocardiography (STE) speckle tracking. By involving 61 SKA patients, this study sought to provide deeper insight into the relationship between the two parameters.
Results
The analysis conducted revealed a significant negative correlation between FS and GLS values, with Spearman R values of -0.603 and P <0.01. These results indicate that the lower the FS value, the worse the GLS value is obtained. In addition, FS which is less than 25% can be used significantly to distinguish the GLS value of more than -10.4% from the better GLS value, which is less than -10.4%, in the context of predicting the prognosis and myocardial remodeling.
The combination of FS is less than 25% and the Simpson ejection fraction (EF) of less than 50% can predict the GLS value with a linear regression equation that has an interception -16.06. In addition, the strength of determination (R²) for EF Simpson increases when added to the FS value. Furthermore, FS which is less than 25% also increases the risk of non-Fatal cardiovascular complications in 30 days with a Hazard Ratio (HR) of 1.5 (1.01-2.5) with a p <0.01.
Conclusion
The FS value has an important role as a predictor for GLS values related to the prognosis, repair, and left ventricular remodeling after SKA. With this information, the use of FS as a diagnostic tool can make a significant contribution in SKA patient management, so it is expected to increase the patient's clinical outcome and long-term prognosis. Further research needs to be done to deepen understanding of the mechanisms and clinical applications of FS and GLS measurements in the context of coronary heart disease.
Implications for Clinical Practice
The findings of this study have significant implications for clinical practice. The use of FS as a predictor of GLS values can help clinicians to identify patients who are at high risk of left ventricular dysfunction and myocardial remodeling. This information can be used to tailor treatment strategies and improve patient outcomes. Furthermore, the use of FS as a diagnostic tool can help to reduce the need for more complex and expensive methods, such as GLS.
Future Research Directions
Further research is needed to deepen understanding of the mechanisms and clinical applications of FS and GLS measurements in the context of coronary heart disease. This includes studies to investigate the relationship between FS and GLS in different patient populations, as well as studies to explore the use of FS as a predictor of other cardiovascular outcomes.
Limitations of the Study
This study has several limitations. The sample size was relatively small, and the study was conducted in a single hospital setting. Further studies are needed to confirm the findings of this study and to explore the generalizability of the results.
Conclusion
In conclusion, this study has demonstrated the importance of FS as a predictor of GLS values in acute coronary syndrome patients. The use of FS as a diagnostic tool can make a significant contribution in SKA patient management, so it is expected to increase the patient's clinical outcome and long-term prognosis. Further research needs to be done to deepen understanding of the mechanisms and clinical applications of FS and GLS measurements in the context of coronary heart disease.Frequently Asked Questions (FAQs) about the Relationship of Fractional Shortening Value with Global Longitudinal Left Ventricular Strain in Acute Coronary Syndrome Patients
Q: What is Fractional Shortening (FS) and how is it related to Global Longitudinal Strain (GLS)?
A: Fractional Shortening (FS) is a widely used echocardiographic parameter that measures the percentage of left ventricular shortening during systole. It is a simple and non-invasive method that can provide valuable information about left ventricular function. Global Longitudinal Strain (GLS) is a more advanced echocardiographic parameter that measures the deformation of the left ventricle in multiple directions. The study found a significant negative correlation between FS and GLS values, indicating that the lower the FS value, the worse the GLS value is obtained.
Q: What is the significance of the study's findings?
A: The study's findings have significant implications for clinical practice. The use of FS as a predictor of GLS values can help clinicians to identify patients who are at high risk of left ventricular dysfunction and myocardial remodeling. This information can be used to tailor treatment strategies and improve patient outcomes.
Q: How can FS be used in clinical practice?
A: FS can be used as a diagnostic tool to identify patients who are at high risk of left ventricular dysfunction and myocardial remodeling. It can also be used to monitor the progression of left ventricular dysfunction and to evaluate the effectiveness of treatment.
Q: What are the limitations of the study?
A: The study has several limitations, including a relatively small sample size and a single hospital setting. Further studies are needed to confirm the findings of this study and to explore the generalizability of the results.
Q: What are the future research directions?
A: Further research is needed to deepen understanding of the mechanisms and clinical applications of FS and GLS measurements in the context of coronary heart disease. This includes studies to investigate the relationship between FS and GLS in different patient populations, as well as studies to explore the use of FS as a predictor of other cardiovascular outcomes.
Q: How can clinicians use the study's findings to improve patient outcomes?
A: Clinicians can use the study's findings to identify patients who are at high risk of left ventricular dysfunction and myocardial remodeling. They can also use FS as a diagnostic tool to monitor the progression of left ventricular dysfunction and to evaluate the effectiveness of treatment.
Q: What are the potential benefits of using FS as a diagnostic tool?
A: The potential benefits of using FS as a diagnostic tool include improved patient outcomes, reduced healthcare costs, and enhanced quality of life.
Q: What are the potential risks of using FS as a diagnostic tool?
A: The potential risks of using FS as a diagnostic tool include false positives or false negatives, which can lead to unnecessary treatment or delayed diagnosis.
Q: How can clinicians ensure the accuracy of FS measurements?
A: Clinicians can ensure the accuracy of FS measurements by using high-quality echocardiographic equipment, following standardized protocols, and interpreting the results in the context of the patient's clinical presentation.
Q: What are the future implications of the study's findings?
A: The study's findings have significant implications for the future of cardiovascular medicine. They suggest that FS can be used as a diagnostic tool to identify patients who are at high risk of left ventricular dysfunction and myocardial remodeling. This information can be used to tailor treatment strategies and improve patient outcomes.