scholarly journals Global work index by non-invasive pressure-strain loops: a novel parameter to assess left ventricular performance in the early stages of heart failure with preserved or mid-range ejection fraction after acute myocardial infarction

2020 ◽  
Author(s):  
Raluca Tomoaia ◽  
Ruxandra Stefana Beyer ◽  
Dumitru Zdrenghea ◽  
Alexandra Dadarlat-Pop ◽  
Gabriel Cismaru ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Performance ◽  
Non Invasive ◽  
Early Stages

Aim: To determine the relationship between myocardial work (MW) indices derived from non-invasive pressure-strain loops (PSL) and established parameters of left ventricular (LV) performance in patients with acute myocardial infarction (AMI) and heart failure (HF) with preserved or mid-range ejection fraction (HFpEF/HFmrEF).Material and methods: Speckle-tracking echocardiography (STE) was used to determine MW indices and global longitudinal strain (GLS) in the first 24-48 hours after admission in patients with AMI, HF symptoms, NT-proBNP >300 pg/mL and left ventricular ejection fraction (LVEF) >40%. MW was calculated by using PSL, which combine strain and non-invasive blood pressure  measurement. Global MW index (GWI) was defined as the work inside the area of the PSL.Results: Forty-nine patients (mean age 68±13 years) fulfilled the inclusion criteria. Both GWI (1057±338 mmHg%) and GLS (-10.4±3.3%) were reduced in the majority of the patients. However, a proportion of patients with abnormal GLS showed normal GWI. There was a strong inverse relationship between GWI and GLS (r=-0.81). GWI demonstrated a strong relationship with LVEF (r=0.69) and a moderate correlation to NT-proBNP (n=-0.29). NT-proBNP showed a tendency to higher values in patients with more reduced GWI (820 [590-2550] vs 707 [460-1335], p=0.17). Out of the diastolic dysfunction parameters, GWI showed moderate correlations to LA volume index (r-0.29), E/A (r=-0.23) and E/e’ (r=-0.39), which were also significantly more impaired in patients with more reduced GWI.Conclusion: Non-invasive PSL might bring further information to LVEF and GLS in patients AMI at the early stages of HFpEF/HFmrEF, since LV performance depends on both contractile properties and variations in load in the ischemic segments.

Heart failure is a common complication after acute myocardial infarction in patients with diabetes: A nationwide study in the SWEDEHEART registry

2020 ◽  
Vol 27 (17) ◽  
pp. 1890-1901 ◽  
Author(s):  
Viveca Ritsinger ◽  
Thomas Nyström ◽  
Nawsad Saleh ◽  
Bo Lagerqvist ◽  
Anna Norhammar
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Common Complication ◽  
Ventricular Ejection Fraction ◽  
Patients With Diabetes

Background Several glucose lowering drugs with preventive effects on heart failure and death have entered the market, however, still used in low proportions after acute myocardial infarction. We explored the complication rates of heart failure and death after acute myocardial infarction in patients with and without diabetes. Methods All patients ( N = 73,959) with acute myocardial infarction admitted for coronary angiography included in the SWEDEHEART registry during the years 2012–2017 were followed for heart failure (until 31 December 2017) and mortality (until 30 June 2018); mean follow-up time 1223 (SD ± 623) days. Results Mean age was 69 years (SD ± 12), 69% were male and 24% had diabetes. Heart failure occurred more often in diabetes (22% vs. 12% if no diabetes), especially if previous MI (33% vs. 23%). Patients with diabetes had increased risk of HF regardless of previous myocardial infarction (MI); with previous MI adjusted hazard ratio 2.09 (95% confidence interval 1.96–2.20) and without MI 1.52 (1.44–1.61) respectively when non-diabetes patients with first MI served as reference. In patients with no previous heart failure or MI and discharged with left ventricular ejection fraction ≥50% the risk of heart failure was particularly high in those with diabetes (1.56; 1.39–1.76) when compared with those without. Similar findings were seen for death and combined event (heart failure and death). Conclusions Heart failure is a common complication after acute myocardial infarction in diabetes, increasing the risk by 50–60% regardless of previous heart failure or MI. This risk is present even with normal reported left ventricular ejection fraction, indicating the existence of a large diabetes population at heart failure risk after acute myocardial infarction.

scholarly journals Growth-differentiation factor 15, N-terminal pro-brain natriuretic peptide, structural and functional changes of the heart in patients with heart failure and normal ejection fraction after myocardial infarction on the background of arterial hypertension

2014 ◽  
Vol 18 (1 (69)) ◽  
Author(s):  
V. D. Syvolap ◽  
Ya. V. Zemlianyi
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Arterial Hypertension ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Functional Changes ◽  
Patients With Heart Failure

Levels of GDF-15, NTproBNP, structural and functional changes of the heart were assessed in 69 patients with postinfarction cardiosclerosis and preserved left ventricular ejection fraction (EF>45 %). We found out that patients with heart failure and preserved ejection fraction after myocardial infarction on the background of arterial hypertension have increased levels of GDF 15 and NTproBNP. These biomarkers were correlated with left ventricular diastolic dysfunction and left atrial volume index.

Sign in / Sign up

Export Citation Format

Share Document