Prognostic impact of left ventricular strain by feature tracking in acute myocardial infarction treated with PCI: A meta-analysis

Purpose: To perform a meta-analysis to evaluate the prognostic value of feature tracking (FT)-derived left ventricular (LV) strain parameters in patients following acute myocardial infarction (AMI). Materials and methods: We conducted a comprehensive search of PubMed, Embase, and the Cochrane library for studies published between January 2000 and July 2024, evaluating the prognostic value of FT-derived LV strain parameters in predicting major adverse cardiovascular events (MACE) in patients following AMI. We included studies of patients who underwent cardiac magnetic resonance feature tracking analysis following reperfusion by percutaneous coronary intervention (PCI), as well as reporting multivariate analyses of global longitudinal strain (GLS) or global circumferential strain (GCS). Using RStudio, we calculated pooled hazard ratios (HR) with 95 % confidence intervals (CI) using random-effects models and evaluated heterogeneity with I2 statistics. Results: Nine studies involving 3651 patients were included. Seven studies focused on GLS, while five evaluated GCS in relation to MACE. The meta-analysis revealed a significant association between GLS and MACE occurrence (HR 1.15; 95 % CI: 1.07-1.23; I2 = 76 %; p <= 0.0001). For GCS, the pooled HR was 1.11 (95 % CI: 1.04-1.19; I2 = 50 %; p = 0.0024). However, a leave-one-out sensitivity analysis showed that the prognostic effect of GCS was not robust, as the pooled HR adjusted to 1.09 (95 % CI: 1.00-1.19). Conclusion: GLS was identified as a sensitive marker of early myocardial injury with incremental prognostic value, potentially enhancing risk stratification for post-AMI patients. Conversely, GCS did not demonstrate a significant prognostic effect.