Changes in global left ventricular myocardial work indices and stunning detection 3 months after ST-segment elevation myocardial infarction
| Autor: | Mohammed El Mahdiui, Jeroen J. Bax, Nina Ajmone Marsan, José M. Montero-Cabezas, Marina V Kostyukevich, Federico Fortuni, Juhani Knuuti, Rodolfo P. Lustosa, Pieter van der Bijl, Victoria Delgado |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Systole Heart Ventricles medicine.medical_treatment Blood Pressure Ventricular Function Left Percutaneous Coronary Intervention Interquartile range Internal medicine medicine Humans ST segment Myocardial infarction Retrospective Studies Myocardial Stunning Myocardial stunning Ejection fraction Troponin T business.industry Percutaneous coronary intervention Stroke Volume Middle Aged Prognosis medicine.disease Myocardial Contraction Blood pressure Echocardiography Cardiology ST Elevation Myocardial Infarction Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Journal of Cardiology, 157, 15-21. EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC |
| Popis: | Global left ventricular (LV) myocardial work (MW) indices (GLVMWI) are derived from speckle tracking echocardiographic strain data in combination with non-invasive blood pressure measurements. Changes in global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) after ST-segment elevation myocardial infarction (STEMI) have not been explored. The aim of present study was to assess the evolution of GLVMWI in STEMI patients from baseline (index infarct) to 3 months' follow-up. Three-hundred and fifty patients (265 men; mean age 61 +/- 10 years) with STEMI treated with primary percutaneous coronary intervention (PCI) and guideline-based medical therapy were retrospectively evaluated. Clinical variables, conventional echocardiographic measures and GLVMWI were recorded at baseline within 48 hours post-primary PCI and 3 months' follow-up. LV ejection fraction (from 54 +/- 10% to 57 +/- 10%, p < 0.001), GWI (from 1449 +/- 451 mm Hg% to 1953 +/- 492 mm Hg%, p < 0.001), GCW (from 1624 +/- 519 mm Hg% to 2228 +/- 563 mm Hg%, p < 0.001) and GWE (from 93% (interquartile range (IQR) 86%-95%) to 95% (IQR 91%-96%), p < 0.001) improved significantly at 3 months' follow-up with no significant difference in GWW (from 101 mm Hg% (IQR 63-155 mm Hg%) to 96 mm Hg% (IQR 64-155 mm Hg %); p = 0.535). On multivariable linear regression analysis, lower values of troponin T at baseline, increase in systolic blood pressure and improvement in LV global longitudinal strain were independently associated with higher GWI and GCW at 3 months' follow-up. In conclusion, the evolution of GWI, GCW and GWE in STEMI patients may reflect myocardial stunning, whereas the stability in GWW may reflect permanent myocardial damage and the development of non-viable scar tissue. (C) 2021 The Authors. Published by Elsevier Inc. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|