AIM: To conduct a systematic review relating myocardial strain assessed by different imaging modalities for prognostication following ST-elevation myocardial infarction(STEMI).METHODS: An online literature search was performed in Pub Med and OVID® electronic databases to identify any studies that assessed global myocardial strain parameters using speckle-tracking echocardiography(STE) and/or cardiac magnetic resonance imaging(CMR) techniques [either myocardial tagging or feature tracking(FT) software] in an acute STEMI cohort(days 0-14 post-event) to predict prognosis [either development of major adverse cardiac events(MACE)] or adverse left ventricular(LV) remodelling at follow-up(≥ 6 mo for MACE,≥ 3 mo for remodelling). Search was restricted to studies within the last 20 years. All studies that matched the pre-defined search criteria were reviewed and their results interpreted. Due to considerable heterogeneity between studies,metaanalysis was not performed.RESULTS: A total of seven studies(n = 7) were identified that matched the search criteria. All studies used STE to evaluate strain parameters- five(n = 5) assessed global longitudinal strain(GLS)(n = 5),one assessed GLS rate(GLS-R)(n = 1) and one assessed both(n = 1). Three studies showed that GLS independently predicted the development of adverse LV remodelling by multivariate analysis- odds ratio between 1.19(CI: 1.04-1.37,P < 0.05) and 10(CI: 6.7-14,P < 0.001) depending on the study. Four studies showed that GLS predicted the development of MACE- hazard ratio(HR) between 1.1(CI: 1-1.1,P = 0.006) and 2.34(1.10-4.97,P < 0.05). One paper found that GLS-R could significantly predict MACEHR 18(10-35,P < 0.001)- whilst another showed it did not. GLS <-10.85% had sensitivity/specificity of 89.7%/91% respectively for predicting the development of remodelling whilst GLS <-13% could predict the development of MACE with sensitivity/specificity of 100%/89% respectively. No suitable studies were identified that assessed global strain by CMR tagging or FT techniques.CONCLUSION: GLS measured acutely post-STEMI by STE is a predictor of poor prognosis. Further research is needed to show that this is true for CMR-based techniques. AIM: To conduct a systematic review of myocardial strains assessed by different imaging modalities for prognostication following ST-elevation myocardial infarction (STEMI). METHODS: An online literature search was performed in Pub Med and OVID® electronic databases to identify any studies that represented global myocardial strain parameters using speckle-tracking echocardiography (STE) and / or cardiac magnetic resonance imaging (CMR) techniques [either myocardial tagging or feature tracking (FT) software] in an acute STEMI cohort (days 0-14 post-event) to predict prognosis [either development of major adverse cardiac events (MACE)] or adverse left ventricular (LV) remodeling at follow-up (≥ 6 mo for MACE, ≥ 3 mo for remodeling). Search was restricted to studies within the last 20 years. All studies that matched the pre-defined search criteria were reviewed and their results interpreted. Due to considerable heterogeneity between studies, metaanalysis was not performed .RESULTS: A total of s All studies used STE to evaluate the strain parameters-five (n = 5) assessed global longitudinal strain (GLS) (n = 5), one assessed GLS rate (GLS- Three studies showed that GLS independently predicted the development of adverse LV remodeling by multivariate analysis-odds ratio between 1.19 (CI: 1.04-1.37, P <0.05) and Four studies showed that GLS predicted the development of MACE-hazard ratio (HR) between 1.1 (CI: 1-1.1, P = 0.006) and 2.34 (1.10 -4.97, P <0.05). One paper found that GLS-R was significantly predictable MACEHR 18 (10-35, P <0.001) - again another showed it did not. GLS <-10.85% had sensitivity / specificity of 89.7% 91% respectively for predicting the development of remodeling while GLS <-13% could predict the development of MACE with sensitivity / specificity of 100% / 89% respectively.ssed global strain by CMR tagging or FT techniques. CONCLUSION: GLS measured acutely post-STEMI by STE is a predictor of poor prognosis. Further research is needed to show that this is true for CMR-based techniques.