Comparison of Global longitudinal peak systolic strain (GLPS) and left ventricular systolic and diastolic function in subjects with early repolarization pattern in ECG and patients with myocardial infarction by speckle tracking echocardiography

The aim of this study was to comparison of GLPS in subjects with ER pattern in ECG with patients with STEMI and healthy subjects by speckle tracking echocardiography.

This case-control study was conducted on 30 patients with STEMI and 19 subjects with ER pattern on ECG admitted to Imam and Golestan hospitals in Ahvaz. The control group was consisted of 30 healthy subjects without cardiovascular disease and with normal ECG. ER pattern, defined as notching or slurring of the terminal part of QRS complex, J-point elevation ≥0.1 mV in more than 2 contiguous leads on ECG and QRS

ST-segment elevation was greater with STEMI group versus ER group (3.57 ± 1.50 vs. 1.68 ± 0.67; p < 0.001). The patients with STEMI had a significant lower ELVF (p < 0.001), SV (p < 0.001), TAPSE (p < 0.001) and LV GLPS (p < 0.001) and higher HR (p < 0.001) and PAP (p < 0.001) compared to ER and control groups, while there was no significant difference between the control and ER group (P>0.05). Mmoreover, the incidence of Left ventricular diastolic dysfunction (LVDD grade 1) in the STEMI group was higher than in two groups of ER and healthy (60%, 10.5% and 9.7%, respectively; P <0.001).

Echocardiography parameters including LVEF, PAP, HR, SV, TAPSE, GLPS and LVDD could be used to differentiate between STEMI and people with ER pattern in ECG.