LA Strain in Predicting Early Complication in STEMI After PPCI

December 5, 2025 updated by: Ahmed Youssef Dandrawy, Assiut University

Left Atrium Strain as a Predictor of In-Hospital Outcomes in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

The goal of this observational study To evaluate the predictive value of left atrial strain for in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing PPCI. The main questions it aims to answer are:

Is low parameters of left atrial strain associated early complication ? What is the correlation between LA strain parameters and conventional echocardiographic indices of left ventricular systolic and diastolic function ? Is there more affection to LA strain in certain territory over the others ? What is the correlation between LA strain and LA volume index across infarct territories ? Does LA strain Correlate with TAPSE and PASP to evaluate right-heart interactions ?

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

The overall trend of ST-segment elevated myocardial infarction has shown an annual increase. Post-infarction heart failure is one of the major adverse cardiovascular events in patients with post-percutaneous coronary intervention.

Therefore, the prediction and accurate assessment of in-hospital outcomes in patients have gained more research and clinical attention.

Left ventricular ejection fraction may no longer be the sole and most reliable predictor of events after a STEMI. Left atrial function may be a comprehensive marker of left-sided cardiac function, as it reflects both diastolic and systolic properties of overall cardiac function.

LA function influences left ventricular filling and cardiac output. Compromised LV function leads to reduced passive LA stretch and filling, contributing to increased LV filling pressures and a subsequent decline in LA function and compliance.

. LA strain is a measurement of atrial myocardial deformation, which is less influenced by cardiac preload and less angle-dependent compared to volumetric indices, such as the left atrial volume index and E/e' ratio.

LA strain is useful in various clinical scenarios, as predicting atrial fibrillation, diastolic dysfunction, and as a measure of LV filling pressure .

LA strain by echocardiographic speckle tracking analysis, is relatively inexpensive, non-invasive and easy to perform, so may be useful as a predictor of in-hospital outcomes.

Previous studies have demonstrated that reduced LA function is linked to clinical outcomes including all-cause mortality.

Study Type

Observational

Enrollment (Estimated)

135

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Egypt
      • Asyut, Egypt
        • Assiut University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

patients diagnosed with ST-segment elevation myocardial infarction and Underwent successful primary percutaneous coronary intervention and control group to provide baseline parameters for comparing LA strain and other echocardiographic parameters

Description

Inclusion Criteria:

  • Adults aged ≥18 years.
  • Diagnosed with ST-segment elevation myocardial infarction (STEMI) according to current ESC/AHA criteria
  • Underwent successful primary percutaneous coronary intervention (PPCI) within 12 hours of symptom onset.
  • Sinus rhythm on admission .
  • Trans thoracic echocardiography (TTE) performed within 48 hours of admission with adequate image quality for speckle-tracking analysis.

Exclusion Criteria:

  • Previous myocardial infarction or prior PCI/CABG.
  • Patients known to have atrial fibrillation or other sustained supraventricular arrhythmias.
  • Significant valvular heart disease (severe stenosis or regurgitation).
  • Congenital heart disease or cardiomyopathy (hypertrophic, dilated, restrictive).
  • Poor echocardiographic window preventing LA strain analysis .
  • Mechanical complications (e.g., papillary muscle rupture, VSD, free wall rupture).
  • Prior cardiac surgery or known structural lesions that preventing reliable LA measurement.
  • patient presenting with killip class III or IV from the start

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
group normal strain
group normal parameters of LA strain by 2D echocardiography
Other: 2D echocardiography
LA strain by 2D echocardiographic speckle tracking analysis
group low strain
group low parameters of LA strain by 2D echocardiography
Other: 2D echocardiography
LA strain by 2D echocardiographic speckle tracking analysis
group control
control group to provide reference for normal parameters of LA strain for age by 2D echocardiography
Other: 2D echocardiography
LA strain by 2D echocardiographic speckle tracking analysis

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
the predictive value of left atrial strain for detecting incidence of in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing primary PCI.
Time Frame: up to one week

To evaluate the predictive value of left atrial strain for hospitalized patients with ST-segment elevation myocardial infarction undergoing primary PCI as regarding

  • All-cause in-hospital mortality
  • New/worsening heart failure requiring IV therapy or ICU care
  • Cardiogenic shock (requiring inotropes or mechanical support)
  • Sustained ventricular arrhythmia (VT/VF)
up to one week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
LA stain vs LAVI
Time Frame: up to one week
Correlation between LA strain and LA volume index (LAVI) across infarct territories
up to one week
LA strain and right side
Time Frame: up to one week
Correlate LA strain with TAPSE and PASP to evaluate right-heart interactions
up to one week
correlation with other parameters
Time Frame: up to one week
Correlation between LA strain parameters (reservoir, conduit, and contractile strain) by speckle tracking echocardiography and conventional echocardiographic indices of left ventricular (LV) systolic and diastolic function (LVEF, LVGLS , E/e', LAVI).
up to one week
LA strain across different territories
Time Frame: up to one week
Compare LA strain (reservoir, conduit, contractile) by speckle tracking echocardiography between anterior (LAD-territory) vs inferior (RCA/LCx-territory) STEMI as which territory would have more affection to LA strain
up to one week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Principal Investigator: Doaa A Fouad, Professor, Assiut University
  • Principal Investigator: Magdy I Algowhary, Assistant Professor, Assiut University
  • Principal Investigator: Ahmed G Bakry, Assistant Professor, South Valley University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 1, 2025

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

February 1, 2027

Study Registration Dates

First Submitted

November 16, 2025

First Submitted That Met QC Criteria

November 21, 2025

First Posted (Estimated)

December 4, 2025

Study Record Updates

Last Update Posted (Actual)

December 12, 2025

Last Update Submitted That Met QC Criteria

December 5, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • left atrial strain in STEMI

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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