Background: Achieving optimal angiographic coronary flow after acute ST elevation myocardial infarction (STEMI) isn't the best parameter of success. Perfusion of the microvasculature is more important. QRS score plays an important role for early risk stratification for STEMI. It is a simple electrocardiographic (ECG) parameter for assuring the presence or absence of microvascular obstruction. Aim of the work: The aim of this clinical study is to validate the 90 minutes modified Selvester QRS score reduction as a reliable predictor of myocardial salvage, represented by 3 months global longitudinal strain (GLS) value, following successful reperfusion of acute STEMI. Material/Methods: The study population included 400 patients presented with first acute STEMI with successful reperfusion by thrombolysis (Group I-200 patients: mean age=57.1 ± 11.6 years) or primary percutaneous intervention (PPCI) (Group II-200 patients: mean age=58.2±9.8 years). Basal and 90 minutes after reperfusion electrocardiography was done with assessment of ST resolution and modified Selvester QRS score. Basal and 3 months follow up echocardiography was performed with assessment of ejection fraction (EF) and GLS as an indicator for myocardial salvage with its impact on long-term clinical outcome. Results: 90 minutes ST resolution and QRS score reduction were significantly higher in PPCI group (P.: 0.04*, 0.03*). Patients in group I had non-significant improvement of EF (P.: 0.22) during follow-up, but highly significant improvement of GLS (P.: ˂0.001**) compared to the basal echocardiographic study. Patients in group II had significant improvement of EF (P.: 0.01*) during follow-up, and highly significant improvement of GLS (P.: ˂0.001**) compared to the basal echocardiographic study. As regarding correlation with 3 months GLS value, there was highly significant negative correlation between 3months GLS and (ST resolution and QRS score reduction) (P.: ˂0.001**). Receiver operating characteristics (ROC) curve analysis shows that 90 minutes QRS score reduction has the best cut off value of 70% to predict 3months GLS improvement with 80% sensitivity and 79% specificity. Conclusions: Modified Selvester QRS score reduction 90 minutes after reperfusion is a cheap bedside ECG parameter added to ST resolution, can be considered as a reliable predictor of future myocardial salvage with its impact on long-term clinical outcome and modifying management strategies.
Background: As a major source of morbidity and mortality, COVID-19 (coronavirus disease 2019) has developed. In both COVID-19 and other pneumonias, high T/I troponin levels may indicate damage to the heart. Objective: ln order to expand our understanding of COVID-19 cardiology effects, as well as provide insights into the features of people who are more prone to cardiovascular diseases. Methods: At isolation hospital in Zagazig, and the isolation hospital in Tripoli, Libya, 42 COVID-19 positive subjects were studied for their echocardiographic parameters, the study was carried out from March 5 th , 2021, to September 4 th 2021. Results: Arrhythmias, myocardial infarctions, valvular dysfunction, pulmonary hypertension, and right ventricular dysfunction (RVD) were found to have no statistically significant association to the severity of COVID-19. Mean of left ventricular ejection fraction (LVEF) was statistically lower among severe COVID-19 patients than moderate and mild cases but means of RV diameter (mm) was statistically higher among severe COVID-19 patients than moderate and mild cases, mean of fractional area change (FAC) was statistically lower in severe COVID-19 patients. Pulmonary hypertension was the second most common echocardiographic finding (38% of patients). There was no statistically significant difference in pulmonary hypertension across COVID-19 patients in relation to the severity (P=0.211). Conclusion:Echocardiography can provide us with important information which can help in managing of patients with COVID-19 while we must consider contamination risks as well as transmission of diseases.
Objective: The aim of the present study was to find new simple non-invasive test can be used in early prediction of the presence of coronary artery disease.
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