Prognostic value of left ventricular global function index in patients after ST-segment elevation myocardial infarction

Eur Heart J Cardiovasc Imaging. 2016 Feb;17(2):169-76. doi: 10.1093/ehjci/jev129. Epub 2015 Jun 7.


Aims: The left ventricular global function index (LVGFI) is a novel indicator of left ventricular performance. Its prognostic value in patients after ST-segment elevation myocardial infarction (STEMI) is unknown. We sought to evaluate the prognostic significance of LVGFI measured by cardiovascular magnetic resonance (CMR) imaging after STEMI.

Methods and results: Two hundred eligible STEMI patients (56 ± 11 years, 16% female) revascularized by primary percutaneous coronary intervention were followed-up for 3.1 [2-4.1] years for major adverse cardiac events (MACE). MACE was defined as a composite of death, non-fatal myocardial re-infarction, and new congestive heart failure. All patients underwent CMR imaging within 2 [2-4] days after STEMI. Late enhancement and cine images were acquired to assess myocardial injury as well as myocardial function, including LVGFI. Patients suffering a MACE event (n = 20, 10%) had a significantly lower LVGFI (P = 0.001). In Kaplan-Meier analysis, a decreased LVGFI was associated with a reduced MACE-free survival (P < 0.001). Multivariate Cox regression analysis revealed a decreased LVGFI as a predictor for MACE [hazard ratio = 4.79, 95% confidence interval (CI) 1.46-15.67, P = 0.010] after adjusting for microvascular obstruction, left ventricular mass, and multivessel disease. In receiver operating characteristic analysis, LVGFI was a strong predictor for MACE (area under the curve = 0.73, CI 0.61-0.85). However, c-statistics revealed that LVGFI does not provide incremental prognostic information over left ventricular ejection fraction (LVEF) (P = 0.38).

Conclusion: LVGFI assessed by CMR is a strong predictor of MACE within 3 years after first STEMI. A superior predictive value as compared with LVEF was not found in this study.

Keywords: Left ventricular global function index; Magnetic resonance imaging; Myocardial infarction; Prognosis.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Cardiac-Gated Imaging Techniques
  • Female
  • Follow-Up Studies
  • Heart Function Tests
  • Humans
  • Image Interpretation, Computer-Assisted
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging, Cine / methods*
  • Male
  • Middle Aged
  • Myocardial Infarction / physiopathology*
  • Myocardial Infarction / surgery*
  • Percutaneous Coronary Intervention*
  • Predictive Value of Tests
  • Prognosis
  • Treatment Outcome
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Dysfunction, Left / surgery*


  • Biomarkers