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Original Research | Cardiology Science | Volume 15 Issue 7, July 2026 | Pages: 1678 - 1683 | India
Dynamics of Global Longitudinal Strain Recovery in St-Elevation Myocardial Infarction: A Prospective Comparative Analysis Between Pharmacoinvasive and Primary PCI Pathways
Abstract: Background: Global longitudinal strain (GLS) connotes highly sensitive biomarker for systolic dysfunction and affords superior modality for assaying myocardial recuperation in comparison with left ventricular ejection fraction (LVEF). In the case of situations where an expeditious primary percutaneous coronary intervention (PPCI) is not possible, the pharmacoinvasive (PI) strategy is followed as an alternative approach to reperfusion. There is scant data in the literature describing the dynamic differences in GLS between these two therapeutic paradigms after an ST-elevation myocardial infarction (STEMI). This inquiry aimed to compare serial GLS, LVEF and ventricular remodeling pathways between cohorts undergoing PPCI and those undergoing PI regime, whilst characterizing strain amelioration determinants over a six week follow up interval. Methods: A prospective and observational approach was applied and 200 patients with STEMI were recruited, divided equally between the PPCI (n = 100) and PI (n = 100) arms. Speckle-tracking echocardiography was used at baseline, the 15 day mark, and at six weeks to determine the GLS, LVEF, and LVEDV. Clinical outcomes and adverse events were carefully documented. Comparative statistics were obtained using t-tests, chi-squares and repeated measures Anova. Results: Baseline GLS, LVEF, and LVEDV values were statistically indistinguishable between the 2 cohorts. Both PPCI and PI groups showed significant improvement in GLS and LVEF over the 6 week period (p < 0.001 for within group changes). At six weeks, GLS had risen to -14.09% in PPCI cohort and -12.64% in PI cohort (p=0.18). Correspondingly, LVEF improved to 46.62 and 46.49% respectively (p = 0.87). Reverse remodeling patterns and clinical outcomes were similar for both treatments. Conclusion: Pharmacoinvasive therapy promotes myocardial functional recovery that is equivalent to primary PCI with similar improvements in GLS, LVEF and ventricular remodeling. When performed in guideline-recommended timeframes, the PI strategy is a reliable option in the management of STEMI.
Keywords: ST-elevation myocardial infarction, Global longitudinal strain, Primary PCI, Pharmacoinvasive therapy, Myocardial recovery
How to Cite?: Dr. Randeep Singh, Dr. Sreenivasa B, Dr. Gurkiran, Dr. Mallesh P, Dr. Dhananjay RS, Dr. Prithipal Singh, "Dynamics of Global Longitudinal Strain Recovery in St-Elevation Myocardial Infarction: A Prospective Comparative Analysis Between Pharmacoinvasive and Primary PCI Pathways", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 1678-1683, https://www.ijsr.net/getabstract.php?paperid=SR26720130819, DOI: https://dx.doi.org/10.21275/SR26720130819