{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:13:15Z","timestamp":1788441195388,"version":"build-2803163510"},"reference-count":30,"publisher":"IMR Press","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"2024 Nantong University Clinical Medicine Special Research Fund","award":["2024LY049"],"award-info":[{"award-number":["2024LY049"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background:While serum potassium abnormalities predict mortality in acute myocardial infarction, whether potassium levels within the normal range influence long-term myocardial functional recovery remains unknown. Therefore, this study aimed to investigate the association between baseline potassium levels and 1-year cardiac magnetic resonance (CMR)-derived global longitudinal strain in patients with ST-segment elevation myocardial infarction (STEMI).Methods:This retrospective cohort study enrolled 120 consecutive patients with STEMI (mean age 52.4 \u00b1 12.6 years, 94.2% male) who underwent primary percutaneous coronary intervention (PCI) and completed 1-year CMR follow-up. Baseline electrolyte levels, including potassium, sodium, chloride, magnesium, ionized calcium, and phosphorus, were measured before the intervention. The primary outcome was 1-year absolute global longitudinal strain (abs_GLS) assessed by CMR feature tracking. Analysis of covariance (ANCOVA) was used to evaluate associations between electrolyte levels and myocardial strain after adjustment for baseline abs_GLS and 16 clinical covariates, including discharge medications.Results:Baseline potassium averaged 3.92 \u00b1 0.26 mmol\/L, with 90% of values ranging from 3.42 to 4.39 mmol\/L. After adjustment for baseline abs_GLS and 16 clinical covariates, potassium was the only electrolyte significantly associated with 1-year abs_GLS in the prespecified primary model. Each 1-SD increase in potassium (0.26 mmol\/L) was associated with a 0.782 percentage-point higher 1-year abs_GLS (95% CI: 0.042\u20131.521, p = 0.041). Categorical analysis showed a nonsignificant trend across potassium tertiles (T1 [&lt;3.82 mmol\/L]: 10.3%; T2 [3.82\u20134.02 mmol\/L]: 11.6%; T3 [&gt;4.02 mmol\/L]: 12.0%; p for trend = 0.159), with the highest tertile exhibiting a 1.7-percentage-point higher adjusted abs_GLS than the lowest tertile.Conclusions:Among patients with STEMI treated with primary PCI, baseline serum potassium, even within the normal range, is independently associated with 1-year myocardial strain recovery, with a trend toward superior outcomes at higher-normal levels. These findings suggest that potassium may serve as a readily available prognostic biomarker for risk stratification; nonetheless, randomized trials are warranted to investigate whether targeted optimization of potassium can improve post-infarction cardiac recovery.<\/jats:p>","DOI":"10.31083\/rcm48335","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:17:46Z","timestamp":1788437866000},"source":"Crossref","is-referenced-by-count":0,"title":["Baseline Serum Potassium Within the Normal Range Is Independently Associated With One-Year Myocardial Strain Recovery in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: A Cardiac Magnetic Resonance Study"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3563-8423","authenticated-orcid":true,"given":"Shancheng","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Radiology, The Affiliated Jiangyin Hospital of Nantong University, Jiangyin Clinical College of Xuzhou Medical University, Jiangyin People\u2019s Hospital, 214400 Jiangyin, Jiangsu, China"},{"name":"Department of Cardiology, Nanjing Chest Hospital, Affiliated Nanjing Brain Hospital, Nanjing Medical University, 210029 Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6835-6951","authenticated-orcid":true,"given":"Jinhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Affiliated Jiangyin Hospital of Nantong University, Jiangyin Clinical College of Xuzhou Medical University, Jiangyin People\u2019s Hospital, 214400 Jiangyin, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4800-4887","authenticated-orcid":true,"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Affiliated Jiangyin Hospital of Nantong University, Jiangyin Clinical College of Xuzhou Medical University, Jiangyin People\u2019s Hospital, 214400 Jiangyin, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8885-4708","authenticated-orcid":true,"given":"Ding","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Affiliated Jiangyin Hospital of Nantong University, Jiangyin Clinical College of Xuzhou Medical University, Jiangyin People\u2019s Hospital, 214400 Jiangyin, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3871-2288","authenticated-orcid":true,"given":"Xianping","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Affiliated Jiangyin Hospital of Nantong University, Jiangyin Clinical College of Xuzhou Medical University, Jiangyin People\u2019s Hospital, 214400 Jiangyin, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3705-2037","authenticated-orcid":true,"given":"Junwei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nanjing Chest Hospital, Affiliated Nanjing Brain Hospital, Nanjing Medical University, 210029 Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2140-2685","authenticated-orcid":true,"given":"Wei","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Third Affiliated Hospital of Soochow University, 213001 Changzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. European Heart Journal. 2023; 44: 3720\u20133826.","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Gaudron P, Eilles C, Kugler I, Ertl G. Progressive left ventricular dysfunction and remodeling after myocardial infarction. Potential mechanisms and early predictors. Circulation. 1993; 87: 755\u2013763.","DOI":"10.1161\/01.cir.87.3.755"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Podlesnikar T, Pizarro G, Fern\u00e1ndez-Jim\u00e9nez R, Montero-Cabezas JM, Greif N, S\u00e1nchez-Gonz\u00e1lez J, et al. Left ventricular functional recovery of infarcted and remote myocardium after ST-segment elevation myocardial infarction (METOCARD-CNIC randomized clinical trial substudy). Journal of Cardiovascular Magnetic Resonance. 2020; 22: 44.","DOI":"10.1186\/s12968-020-00638-8"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Velagaleti RS, Pencina MJ, Murabito JM, Wang TJ, Parikh NI, D'Agostino RB, et al. Long-term trends in the incidence of heart failure after myocardial infarction. Circulation. 2008; 118: 2057\u20132062.","DOI":"10.1161\/CIRCULATIONAHA.108.784215"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal. 2018; 39: 119\u2013177.","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Goyal A, Spertus JA, Gosch K, Venkitachalam L, Jones PG, Van den Berghe G, et al. Serum potassium levels and mortality in acute myocardial infarction. JAMA. 2012; 307: 157\u2013164.","DOI":"10.1001\/jama.2011.1967"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Zhang X, Wang M, Zhu Z, Qu H, Gu J, Ni T, et al. Serum potassium level, variability and in-hospital mortality in acute myocardial infarction. European Journal of Clinical Investigation. 2022; 52: e13772.","DOI":"10.1111\/eci.13772"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Zhou Y, Chen Y, Liang S, Li Y, Zhao C, Wu Z. Association between potassium fluctuation and in-hospital mortality in acute myocardial infarction patients: a retrospective analysis of the MIMIC-IV database. Clinical Research in Cardiology. 2025.  (online ahead of print)","DOI":"10.1007\/s00392-025-02613-8"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Weiss JN, Qu Z, Shivkumar K. Electrophysiology of Hypokalemia and Hyperkalemia. Circulation. Arrhythmia and Electrophysiology. 2017; 10: e004667.","DOI":"10.1161\/CIRCEP.116.004667"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Gavara J, Rodriguez-Palomares JF, Valente F, Monmeneu JV, Lopez-Lereu MP, Bonanad C, et al. Prognostic Value of Strain by Tissue Tracking Cardiac Magnetic Resonance After ST-Segment Elevation Myocardial Infarction. JACC. Cardiovascular Imaging. 2018; 11: 1448\u20131457.","DOI":"10.1016\/j.jcmg.2017.09.017"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Romano S, Judd RM, Kim RJ, Kim HW, Klem I, Heitner JF, et al. Feature-Tracking Global Longitudinal Strain Predicts Death in a Multicenter Population of Patients With Ischemic and Nonischemic Dilated Cardiomyopathy Incremental to Ejection Fraction and Late Gadolinium Enhancement. JACC. Cardiovascular Imaging. 2018; 11: 1419\u20131429.","DOI":"10.1016\/j.jcmg.2017.10.024"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Reindl M, Tiller C, Holzknecht M, Lechner I, Beck A, Plappert D, et al. Prognostic Implications of Global Longitudinal Strain by Feature-Tracking Cardiac Magnetic Resonance in ST-Elevation Myocardial Infarction. Circulation: Cardiovascular Imaging. 2019; 12: e009404.","DOI":"10.1161\/CIRCIMAGING.119.009404"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Eitel I, Stiermaier T, Lange T, Rommel KP, Koschalka A, Kowallick JT, et al. Cardiac Magnetic Resonance Myocardial Feature Tracking for Optimized Prediction of Cardiovascular Events Following Myocardial Infarction. JACC. Cardiovascular Imaging. 2018; 11: 1433\u20131444.","DOI":"10.1016\/j.jcmg.2017.11.034"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Weiss KJ, Ching S, Doeblin P, Carri\u00f3n-S\u00e1nchez I, Carrizosa K, Tanacli R, et al. Reference Values for Myocardial Strain by Cardiac Magnetic Resonance Feature Tracking: Insights From Healthy Volunteers and Heart Failure Patients Using Caas MR. Reviews in Cardiovascular Medicine. 2026; 27: 41521.","DOI":"10.31083\/RCM41521"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Altman DG, Bland JM. Quartiles, quintiles, centiles, and other quantiles. BMJ (Clinical Research Ed.). 1994; 309: 996.","DOI":"10.1136\/bmj.309.6960.996"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Greenland S. Avoiding power loss associated with categorization and ordinal scores in dose-response and trend analysis. Epidemiology (Cambridge, Mass.). 1995; 6: 450\u2013454.","DOI":"10.1097\/00001648-199507000-00025"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Krogager ML, Eggers-Kaas L, Aasbjerg K, Mortensen RN, K\u00f8ber L, Gislason G, et al. Short-term mortality risk of serum potassium levels in acute heart failure following myocardial infarction. European Heart Journal. Cardiovascular Pharmacotherapy. 2015; 1: 245\u2013251.","DOI":"10.1093\/ehjcvp\/pvv026"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Jensen CJ, Nielsen JK, Talbott MM, O'Connell D, Patel VS, Armstrong PA, et al. Effects of Serum Potassium on Mortality in Patients With ST-Elevation Myocardial Infarction. Cureus. 2024; 16: e61126.","DOI":"10.7759\/cureus.61126"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. Lancet (London, England). 1995; 345: 669\u2013685.","DOI":"10.1016\/S0140-6736(95)90865-X"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Grandi E, Sanguinetti MC, Bartos DC, Bers DM, Chen-Izu Y, Chiamvimonvat N, et al. Potassium channels in the heart: structure, function and regulation. The Journal of Physiology. 2017; 595: 2209\u20132228.","DOI":"10.1113\/JP272864"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Amin AS, Tan HL, Wilde AAM. Cardiac ion channels in health and disease. Heart Rhythm. 2010; 7: 117\u2013126.","DOI":"10.1016\/j.hrthm.2009.08.005"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Nerbonne JM, Kass RS. Molecular physiology of cardiac repolarization. Physiological Reviews. 2005; 85: 1205\u20131253.","DOI":"10.1152\/physrev.00002.2005"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"O'Rourke B. Mitochondrial ion channels. Annual Review of Physiology. 2007; 69: 19\u201349.","DOI":"10.1146\/annurev.physiol.69.031905.163804"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Gross GJ, Fryer RM. Sarcolemmal versus mitochondrial ATP-sensitive K+ channels and myocardial preconditioning. Circulation Research. 1999; 84: 973\u2013979.","DOI":"10.1161\/01.res.84.9.973"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Mu\u00f1oz-Planillo R, Kuffa P, Mart\u00ednez-Col\u00f3n G, Smith BL, Rajendiran TM, N\u00fa\u00f1ez G. K\u207a efflux is the common trigger of NLRP3 inflammasome activation by bacterial toxins and particulate matter. Immunity. 2013; 38: 1142\u20131153.","DOI":"10.1016\/j.immuni.2013.05.016"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Toldo S, Abbate A. The NLRP3 inflammasome in acute myocardial infarction. Nature Reviews. Cardiology. 2018; 15: 203\u2013214.","DOI":"10.1038\/nrcardio.2017.161"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Gu Q, Tang C, Yang B, Shi F, Gu X, Zhu J. Prediction of hypokalemia in patients with ST-segment elevation myocardial infarction: development and validation of a model with prehospital applicability. Frontiers in Cardiovascular Medicine. 2026; 13: 1776702.","DOI":"10.3389\/fcvm.2026.1776702"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Palmer BF, Clegg DJ. Diagnosis and treatment of hyperkalemia. Cleveland Clinic Journal of Medicine. 2017; 84: 934\u2013942.","DOI":"10.3949\/ccjm.84a.17056"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Brann A, Miller J, Eshraghian E, Park JJ, Greenberg B. Global longitudinal strain predicts clinical outcomes in patients with heart failure with preserved ejection fraction. European Journal of Heart Failure. 2023; 25: 1755\u20131765.","DOI":"10.1002\/ejhf.2947"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Figtree GA, Vernon ST, Hadziosmanovic N, Sundstr\u00f6m J, Alfredsson J, Arnott C, et al. Mortality in STEMI patients without standard modifiable risk factors: a sex-disaggregated analysis of SWEDEHEART registry data. Lancet (London, England). 2021; 397: 1085\u20131094.","DOI":"10.1016\/S0140-6736(21)00272-5"}],"container-title":["Reviews in Cardiovascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/27\/8\/10.31083\/RCM48335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:18:56Z","timestamp":1788437936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/27\/8\/10.31083\/RCM48335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1530-6550(26)03490-0"],"URL":"https:\/\/doi.org\/10.31083\/rcm48335","relation":{},"ISSN":["1530-6550","2153-8174"],"issn-type":[{"value":"1530-6550","type":"print"},{"value":"2153-8174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"48335"}}