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Background <p>To evaluate potential effects of adenosine (ADO) administration on global longitudinal strain (GLS) and mechanical dispersion (MD) in ST-segment elevation myocardial infarction (STEMI), as ischemia-reperfusion injury may be reduced by ADO.</p> Methods <p>At 7 ± 2 days after successfully treated STEMI, 49 patients (age 63 ± 11 years, 35 male) underwent rest/stress echocardiography by intravenous administration of ADO at 140 mcg/Kg/minute for 90&#xa0;s. Resting echocardiography was repeated after 6-months. Thirty sex and age-matched subjects were considered as controls to set normal response of GLS and MD to ADO. GLS and MD were assessed in all time points. Contractile recovery at follow-up was defined by GLS values ≥ 20% at 6 months after STEMI.</p> Results <p>At baseline, resting GLS was lower (<i>p</i> &lt; 0.001) and MD greater (<i>p</i> &lt; 0.001) in patients than controls. In patients, ADO administration reduced MD (<i>p</i> &lt; 0.001 vs. rest), without effect on GLS, while opposite response was found in controls. In STEMI, both GLS and MD significantly improved at follow-up, compared to baseline (20 ± 3 vs. 17 ± 4%, <i>p</i> &lt; 0.001; 36 ± 9 vs. 46 ± 31 msec, <i>p</i> = 0.030, respectively). Resting MD ≤ 41.9 msec or stress MD ≤ 17.7 msec, resting GLS ≥ 16.5% and troponin peak ≤ 117 ng/mL at baseline predicted contractile recovery at follow-up (AUC 0.745, 0.742, 0.768 and 0.801, respectively, <i>p</i> &lt; 0.0.05 for all).</p> Conclusions <p>In the sub-acute phase of first optimally treated STEMI, ADO improves MD but not GLS. Both GLS and MD improve at follow-up. Lower is rest or stress MD at baseline, greater is GLS at follow-up.</p>

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Effect of adenosine stimulation on global longitudinal strain and mechanical dispersion in the sub-acute phase of ST-segment elevation myocardial infarction

  • 期刊论文

  • 发表日期：

    2026年2月18日

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  • Laura Manfredonia,
  • Gabriella Locorotondo,
  • Monica Filice,
  • Eleonora Ruscio,
  • Emanuele Salvatore Ravenna,
  • Francesca Graziani,
  • Giovanna Liuzzo,
  • Antonella Lombardo,
  • Massimo Massetti,
  • Francesco Burzotta,
  • Gaetano Antonio Lanza

摘要

Background

To evaluate potential effects of adenosine (ADO) administration on global longitudinal strain (GLS) and mechanical dispersion (MD) in ST-segment elevation myocardial infarction (STEMI), as ischemia-reperfusion injury may be reduced by ADO.

Methods

At 7 ± 2 days after successfully treated STEMI, 49 patients (age 63 ± 11 years, 35 male) underwent rest/stress echocardiography by intravenous administration of ADO at 140 mcg/Kg/minute for 90 s. Resting echocardiography was repeated after 6-months. Thirty sex and age-matched subjects were considered as controls to set normal response of GLS and MD to ADO. GLS and MD were assessed in all time points. Contractile recovery at follow-up was defined by GLS values ≥ 20% at 6 months after STEMI.

Results

At baseline, resting GLS was lower (p < 0.001) and MD greater (p < 0.001) in patients than controls. In patients, ADO administration reduced MD (p < 0.001 vs. rest), without effect on GLS, while opposite response was found in controls. In STEMI, both GLS and MD significantly improved at follow-up, compared to baseline (20 ± 3 vs. 17 ± 4%, p < 0.001; 36 ± 9 vs. 46 ± 31 msec, p = 0.030, respectively). Resting MD ≤ 41.9 msec or stress MD ≤ 17.7 msec, resting GLS ≥ 16.5% and troponin peak ≤ 117 ng/mL at baseline predicted contractile recovery at follow-up (AUC 0.745, 0.742, 0.768 and 0.801, respectively, p < 0.0.05 for all).

Conclusions

In the sub-acute phase of first optimally treated STEMI, ADO improves MD but not GLS. Both GLS and MD improve at follow-up. Lower is rest or stress MD at baseline, greater is GLS at follow-up.