Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania

Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania

Diana Aurora Bordejevic,1 Tudor Pârvănescu,2 Lucian Petrescu,1 Cristian Mornoș,1 Ioan Olariu,1 Simina Crișan,1 Cristina Văcărescu,1 Mihai Lazăr,1 Vlad Ioan Morariu,2 Ioana Mihaela Citu,2 Mirela Cleopatra Tomescu,2 Dragoș Cozma1 1Cardiology Department, Institute of Cardiovascular Diseases,...

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Autores principales: Bordejevic DA, Pârvănescu T, Petrescu L, Mornoș C, Olariu I, Crișan S, Văcărescu C, Lazăr M, Morariu VI, Citu IM, Tomescu MC, Cozma D
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2021
Materias:
ami
pci
preserved lvef
midrange lvef
2d speckle tracking echocardiography
lv remodeling
Therapeutics. Pharmacology
RM1-950
Acceso en línea:https://doaj.org/article/938110b8de4246c0aa386bff870eb971
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spelling oai:doaj.org-article:938110b8de4246c0aa386bff870eb9712021-12-02T11:41:55ZLeft Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania1178-203Xhttps://doaj.org/article/938110b8de4246c0aa386bff870eb9712021-03-01T00:00:00Zhttps://www.dovepress.com/left-ventricular-remodeling-risk-predicted-by-two-dimensional-speckle--peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XDiana Aurora Bordejevic,1 Tudor Pârvănescu,2 Lucian Petrescu,1 Cristian Mornoș,1 Ioan Olariu,1 Simina Crișan,1 Cristina Văcărescu,1 Mihai Lazăr,1 Vlad Ioan Morariu,2 Ioana Mihaela Citu,2 Mirela Cleopatra Tomescu,2 Dragoș Cozma1 1Cardiology Department, Institute of Cardiovascular Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 2Cardiology Department, City Hospital, Victor Babes University of Medicine and Pharmacy, Timisoara, RomaniaCorrespondence: Tudor Pârvănescu; Ioana Mihaela CituVictor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, Timișoara 300041, RomaniaTel +40 724 369729; +40 723 280 623Fax +40 256 220636Email tudorparvanescu@gmail.com; ioanamihaela2010@gmail.comBackground: Patients with acute myocardial infarction (AMI) are at high risk for left ventricular (LV) remodeling and heart failure. We aimed to study whether LV strains (S) and strain rates (SR) could predict cardiac remodeling in patients with AMI having a midrange or preserved LV ejection fraction (EF) following a percutaneous coronary intervention (PCI) within the first 12 hours from the onset of symptoms.Patients and Methods: This is a case-control observational study including patients admitted for their first AMI, either with ST-segment elevation (STEMI) or without ST elevation (NSTEMI), with an LVEF > 40% after a successful PCI. Echocardiography was repeated after 6 months, and the patients were divided into two groups, according to whether LV remodeling was determined on echocardiography.Results: Of the 253 AMI patients (mean 66 aged ± 13 years), including 185 males (73%), 61 (24%) presented signs of LV remodeling. In univariate logistic regression analysis, age, male sex, smoking history, hypertension, hypercholesterolemia, Killip class, renal function, peak creatine phosphokinase - MB level, 2- and 3-vessel coronary artery disease (CAD), and several echocardiographic parameters were significantly associated with LV remodeling (P< 0.05). In multivariate logistic regression analysis harmed (H) LS and SR, Killip class, 3-vessel CAD, and LV end-diastolic volume were outlined as independent predictors for LV remodeling. Receiver operating characteristic curve analyses showed that HLS and HLSR were the most powerful independent predictors for LV remodeling (P< 0.001), with an area under the curve (AUC) of 0.85 (sensitivity 83%; specificity 84%; p < 0.001) and 0.77 (sensitivity 93; specificity 61%; p < 0.001), respectively. The identified cut-off values for predictor variables were HLS< − 11%, and HLSR< − 0.65s− 1.Conclusion: We concluded that 2D-STE was the best method to evaluate LV remodeling in patients with AMI and midrange or preserved LVEF following myocardial revascularization by a PCI.Keywords: AMI, PCI, preserved LVEF, midrange LVEF, 2D speckle tracking echocardiography, LV remodelingBordejevic DAPârvănescu TPetrescu LMornoș COlariu ICrișan SVăcărescu CLazăr MMorariu VICitu IMTomescu MCCozma DDove Medical Pressarticleamipcipreserved lvefmidrange lvef2d speckle tracking echocardiographylv remodelingTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 17, Pp 249-258 (2021)
institution DOAJ
collection DOAJ
language EN
topic ami
pci
preserved lvef
midrange lvef
2d speckle tracking echocardiography
lv remodeling
Therapeutics. Pharmacology
RM1-950
spellingShingle ami
pci
preserved lvef
midrange lvef
2d speckle tracking echocardiography
lv remodeling
Therapeutics. Pharmacology
RM1-950
Bordejevic DA
Pârvănescu T
Petrescu L
Mornoș C
Olariu I
Crișan S
Văcărescu C
Lazăr M
Morariu VI
Citu IM
Tomescu MC
Cozma D
Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania
description Diana Aurora Bordejevic,1 Tudor Pârvănescu,2 Lucian Petrescu,1 Cristian Mornoș,1 Ioan Olariu,1 Simina Crișan,1 Cristina Văcărescu,1 Mihai Lazăr,1 Vlad Ioan Morariu,2 Ioana Mihaela Citu,2 Mirela Cleopatra Tomescu,2 Dragoș Cozma1 1Cardiology Department, Institute of Cardiovascular Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 2Cardiology Department, City Hospital, Victor Babes University of Medicine and Pharmacy, Timisoara, RomaniaCorrespondence: Tudor Pârvănescu; Ioana Mihaela CituVictor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, Timișoara 300041, RomaniaTel +40 724 369729; +40 723 280 623Fax +40 256 220636Email tudorparvanescu@gmail.com; ioanamihaela2010@gmail.comBackground: Patients with acute myocardial infarction (AMI) are at high risk for left ventricular (LV) remodeling and heart failure. We aimed to study whether LV strains (S) and strain rates (SR) could predict cardiac remodeling in patients with AMI having a midrange or preserved LV ejection fraction (EF) following a percutaneous coronary intervention (PCI) within the first 12 hours from the onset of symptoms.Patients and Methods: This is a case-control observational study including patients admitted for their first AMI, either with ST-segment elevation (STEMI) or without ST elevation (NSTEMI), with an LVEF > 40% after a successful PCI. Echocardiography was repeated after 6 months, and the patients were divided into two groups, according to whether LV remodeling was determined on echocardiography.Results: Of the 253 AMI patients (mean 66 aged ± 13 years), including 185 males (73%), 61 (24%) presented signs of LV remodeling. In univariate logistic regression analysis, age, male sex, smoking history, hypertension, hypercholesterolemia, Killip class, renal function, peak creatine phosphokinase - MB level, 2- and 3-vessel coronary artery disease (CAD), and several echocardiographic parameters were significantly associated with LV remodeling (P< 0.05). In multivariate logistic regression analysis harmed (H) LS and SR, Killip class, 3-vessel CAD, and LV end-diastolic volume were outlined as independent predictors for LV remodeling. Receiver operating characteristic curve analyses showed that HLS and HLSR were the most powerful independent predictors for LV remodeling (P< 0.001), with an area under the curve (AUC) of 0.85 (sensitivity 83%; specificity 84%; p < 0.001) and 0.77 (sensitivity 93; specificity 61%; p < 0.001), respectively. The identified cut-off values for predictor variables were HLS< − 11%, and HLSR< − 0.65s− 1.Conclusion: We concluded that 2D-STE was the best method to evaluate LV remodeling in patients with AMI and midrange or preserved LVEF following myocardial revascularization by a PCI.Keywords: AMI, PCI, preserved LVEF, midrange LVEF, 2D speckle tracking echocardiography, LV remodeling
format article
author Bordejevic DA
Pârvănescu T
Petrescu L
Mornoș C
Olariu I
Crișan S
Văcărescu C
Lazăr M
Morariu VI
Citu IM
Tomescu MC
Cozma D
author_facet Bordejevic DA
Pârvănescu T
Petrescu L
Mornoș C
Olariu I
Crișan S
Văcărescu C
Lazăr M
Morariu VI
Citu IM
Tomescu MC
Cozma D
author_sort Bordejevic DA
title Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania
title_short Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania
title_full Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania
title_fullStr Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania
title_full_unstemmed Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania
title_sort left ventricular remodeling risk predicted by two-dimensional speckle tracking echocardiography in acute myocardial infarction patients with midrange or preserved ejection fraction in western romania
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/938110b8de4246c0aa386bff870eb971
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