Shock index, modified shock index, and age-adjusted shock index for the prediction of impaired myocardial work in patients with ST-segment elevation myocardial infarction
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: The association between shock index (SI) and myocardial work indices has not been well characterized. This study aimed to validate the value of SI and its variants [modified shock index (MSI) and age-adjusted shock index (ASI)] for predicting myocardial work impairment in patients with ST-segment elevation myocardial infarction (STEMI). Methods: Left ventricular two-dimensional speckle-tracking echocardiography was performed in 37 patients with STEMI and in 37 age-, sex, and cardiovascular risk factor-matched controls. Left ventricular global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency (GWE) were acquired. In males, impaired myocardial work was defined as follows: GLS >-16%, GWI <1,270 mmHg%, GCW <1,650 mmHg%, global wasted work >238 mmHg%, and GWE <90%; meanwhile, in females, it was defined as GLS >-16%, GWI <1,310 mmHg%, GCW <1,544 mmHg%, global wasted work >239 mmHg%, and GWE <91%. Results: 80.49±29.64 mmHg%; P<0.0001). The SI, MSI, and ASI were negatively correlated with GWI (SI: r=-0.788, P<0.0001; MSI: r=-0.748, P<0.0001; ASI: r=-0.647; P<0.0001), and GCW (SI: r=-0.793, P<0.0001; MSI: r=-0.763, P<0.0001; ASI: r=-0.640, P<0.0001). In contrast, all three indices showed significant positive correlations with GLS (SI: r=0.626, P<0.0001; MSI: r=0.623, P<0.0001; ASI: r=0.506, P<0.01). The SI and MSI showed excellent ability in predicting impairment in GWI [area under the receiver operating characteristic curve (AUC) =0.878 and AUC =0.877, respectively] and GCW (AUC =0.876 and AUC =0.869, respectively), which was significantly superior to that of the ASI (AUC =0.765 and AUC =0.759, respectively; P<0.05). Conclusions: The SI and MSI outperform ASI at predicting myocardial work impairment (GWI and GCW) in patients with STEMI. Clinically, the SI or MSI should be prioritized for early risk assessment.
Authors: Jiangli Qiang, Chengyu Sun, Fangli Ye, Donghua Wang, Yanli Lv, Xiaozhi Zheng
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416613592
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