{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T10:45:51Z","timestamp":1782384351464,"version":"3.54.5"},"reference-count":28,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Myocardial infarction with non-obstructive coronary arteries (MINOCA) represents a heterogeneous clinical entity in which patients exhibit symptoms and biomarker evidence of myocardial infarction despite the absence of significant coronary stenosis. This study aimed to evaluate the diagnostic and follow-up value of left ventricular global longitudinal strain (LV-GLS) in patients with MINOCA and to investigate its association with inflammatory and glycemic biomarkers. Methods: A total of 287 patients presenting with acute coronary syndrome were prospectively enrolled. Based on coronary angiographic findings, patients were classified into two groups: myocardial infarction with obstructive coronary arteries (MIOCA; \u226550% stenosis, n = 237) and MINOCA (&lt;50% stenosis, n = 50). In addition, an ischemic control group without obstructive disease (INOCA, n = 50) was included for comparative analysis. Laboratory tests, echocardiography, and LV-GLS were assessed at baseline and at 3 months. Results: Baseline left ventricular ejection fraction (LVEF) and LV-GLS were significantly lower in MIOCA compared with MINOCA (LVEF: 52.9 \u00b1 10.3% vs. 59.7 \u00b1 8.7%, p &lt; 0.001; LV-GLS: \u221211.46 \u00b1 4.84% vs. \u221212.63 \u00b1 6.33%, p = 0.007, respectively). At 3 months, LVEF remained lower in the MIOCA group (57.5 \u00b1 6.6% vs. 62.0 \u00b1 7.9%; p &lt; 0.001, respectively), whereas LV-GLS improved similarly in both groups with no significant difference (\u221215.27 \u00b1 2.60% vs. \u221214.87 \u00b1 5.21%; p = 0.29, respectively). Among MINOCA patients, the neutrophil-to-platelet ratio (NPR) (p = 0.017) and admission glucose (p = 0.047) were independently associated with impaired LV-GLS (defined as values greater than \u221216%). Conclusions: Although LVEF remained higher in MINOCA patients during follow-up, LV-GLS impairment persisted at levels comparable to those observed in MIOCA, suggesting ongoing subclinical myocardial dysfunction. LV-GLS offers superior diagnostic sensitivity to LVEF. Inflammatory and glycemic markers may aid in early risk stratification and guide management in patients with MINOCA.<\/jats:p>","DOI":"10.3390\/jcm15134934","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:14:12Z","timestamp":1782375252000},"page":"4934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Strain Echocardiography in MINOCA: Diagnostic and Follow-Up Implications"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4082-7518","authenticated-orcid":false,"given":"Mustafa Lutfi","family":"Yavuz","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1085-5462","authenticated-orcid":false,"given":"Pelin","family":"Karaca Ozer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6595-4812","authenticated-orcid":false,"given":"Elif","family":"Ayduk Govdeli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Aydo\u011fan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Akif","family":"Parlar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2806-4335","authenticated-orcid":false,"given":"Samim","family":"Emet","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Elitok","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fehmi","family":"Mercanoglu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/j.1365-2796.2012.02591.x","article-title":"Assessing patients with myocardial infarction and nonobstructed coronary arteries (MINOCA)","volume":"273","author":"Beltrame","year":"2013","journal-title":"J. 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