Left ventricular and left atrial deformation imaging early after pPCI: does diabetes mellitus make any difference?
| Autor: | I Mrdovic, L Cucic, M Asanin, L Savic-Spasic, J Vratonjic, N Arnautovic, V Sulovic, S Aleksandric, Gordana Krljanac, D Trifunovic Zamaklar |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Treatment outcome Coronary arteriosclerosis Diastole General Medicine 030204 cardiovascular system & hematology medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Left atrial Heart failure Diabetes mellitus Internal medicine Cardiology medicine Medical imaging Radiology Nuclear Medicine and imaging Systole Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal - Cardiovascular Imaging. 22 |
| ISSN: | 2047-2412 2047-2404 |
| DOI: | 10.1093/ehjci/jeaa356.046 |
| Popis: | Funding Acknowledgements Type of funding sources: None. onbehalf PREDICT-VT More extensive coronary atherosclerosis in diabetes mellitu (DM) induces poorer clinical outcomes after STEMI, but there are data suggesting that impaired myocardial function in DM, even independently from epicardial coronary lesions severity, might have detrimental effect, predominately on heart failure development in DM. Aim the current study is a sub-study of PREDICT-VT study (NCT03263949), aimed to analyse LV and LA function using myocardial deformation imaging based on speckle tracking echocardiography after pPCI in STEMI patients with and without DM. Methods in 307 consecutive pts enrolled in PREDICT-VT study early echocardiography (5 ± 2 days after pPCI) was done including LA and multilayer LV deformation analysis with longitudinal (L), radial (R) and circumferential (C) strain (S; %) and strain rate (SR, 1/sec), LV index of post systolic shortening for longitudinal (PSS LS) and circumferential (PSS CS) strains and analysis of LV rotation mechanic. Results from 242 patients who completed 1 year follow up, 48 (20%) had DM. Pts with DM were older (60 ± 1,01 vs 57 ± 10; p = 0.067) and had insignificantly higher SYNTAX score (18.5 ± 9.2 vs 15.8 ± 9.8, p = 0.118) . However, diabetics had more severely impaired EF (44.2 ± 8.6 vs 49.2 ± 9.8, p = 0.001), E/A ratio (0.78 ± 0.33 vs 0.90 ± 0.34; p = 0.036) and MAPSE (1.18 ± 0.32 vs 1.32 ± 0.33; p = 0.001). Global LV LS on all layers (endo: -13.6 ± 4.0 vs-16.2 ± 4.7; mid: -11.9 ± 3.5 vs -14.1 ± 4.1; epi: -10.4 ± 3.1 vs -12.3 ± 3.6; p Conclusion STEMI patients with DM have more severely impaired LV systolic and diastolic function estimated both by traditional parameter and advanced echo techniques. These results might, at least partially, explain why outcomes after STEMI in DM might be poorer, even in the absence of more complex angiographic findings, pointing to the significance of impaired myocardial function DM itself. |
| Databáze: | OpenAIRE |
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