Assessment of the left atrial volume index and plasma NT-proANP level in patients with acute ST-elevation myocardial infarction

Bacaksız, Ahmet; Vatankulu, Mehmet Akıf; Kayrak, Mehmet; Telli, Hasan Hüseyin; Ayhan, Selim; Sönmez, Osman; Alp, Ayse; Büyükbaş, Sadık

doi:10.6061/clinics/2013(07)18

Cited by 4 publications

(6 citation statements)

References 37 publications

(45 reference statements)

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“…A further reason for the conserved LV function of most AMI patients might be due to timed and successful reperfusion treatment [27]. Finally, the authors suppose that it is probably that NT-ProANP was not elevated significantly either due to depleted stores of atriomyocytic granules one day after the initial maximal release during the early hours of AMI or due to hemodynamic physiological response that might be so effective and resulting in less atrial wall tension.…”

Section: Discussionmentioning

confidence: 99%

“…Song W. et al, exposed decreased concentrations of ANPs in patients with type-2 DM [13]. However, many reports from other studies had shown a significant link between NT-ProANP measures and DM incidence [22,27] Likewise, no variations in the levels of NT-ProANP with the incidence of hypertension were observed in the current study, a finding supported by Niccoli G. et al [22]. In contrast, other studies detected a positive correlation between ANPs and the incidence of hypertension [23,27] There is a dual relationship between the ANP and systemic blood pressure.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of N-terminal fragments of Atrial Natriuretic Neuropeptides (NT-ProANP) with Left Ventricle Ejection Fraction in Cases with Acute Myocardial Infarction

Al-Athari¹

2023

JBB

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BackgroundThis study aimed to assess the correlation of natriuretic neuropeptides (NT-ProANP) with the left ventricular ejection fraction (LVEF) in patients with acute myocardial (AMI). Materials and MethodsThis case-control study composed of 120 patients was recruited from the cardiac center in Babylon, Iraq. The plasma levels of NT-ProANP and echocardiographic measure of the left ventricle ejection fraction percentage (LVEF%) for both patients and controls as well as demographic data were taken. ResultsThe mean ages were 61.9 ± 13.2 and 33.1 ± 8.3 years for patients and control, respectively, 80.8% of the candidates were male. The differences in NT-ProANP serum levels between AMI patients and controls were highly significant p-0.001. There was a good diagnostic ability of NT-ProANP to predict patients with AMI from the healthy subjects by ROC-curve analysis: AUC=0.957, sensitivity=0.961, specificity=0.962, 95%CI=0.927 -0.987, and p>0.05. Whereas, there was a poor diagnostic performance of NT-ProANP to predict LVEF%: AUC=0.438, sensitiv-ity=0.438, specificity=0.519, 95%CI=0.285 -0.598, and p>0.05. Serum concentrations of NT-ProANP showed no significant correlation with the measures of left ventricular EF%, age, and BMI among AMI patients. The serum levels of NT-ProANP revealed no significant variations between AMI patients with low and those with preserved LV functions ConclusionThe study suggests that the measurement of NT-ProANP was not correlated to LVEF%, although its levels were significantly higher among patients with AMI compared to the healthy controls.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Correlation of N-terminal fragments of Atrial Natriuretic Neuropeptides (NT-ProANP) with Left Ventricle Ejection Fraction in Cases with Acute Myocardial Infarction

Al-Athari¹

2023

JBB

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“…In the acute phase of STEMI, histopathological changes in atrial walls include different combinations of ischemia, edema, fibrosis, and stretch, an ideal milieu for NOAF. Previous studies reported that atrial volume and/or functional changes can predict inhospital NOAF development in STEMI . However, these changes do not truly reflect early histopathological remodeling .…”

Section: Introductionmentioning

confidence: 94%

“…Previous studies reported that atrial volume and/or functional changes can predict inhospital NOAF development in STEMI. [8][9][10] However, these changes do not truly reflect early histopathological remodeling. 11 Atrial dyssynchrony refers to dispersions of electromechanical conduction times at septal and lateral mitral annulus (left atrial (LA) dyssynchrony) as well as at lateral mitral and tricuspid annulus (inter-atrial dyssynchrony).…”

Section: Introductionmentioning

confidence: 99%

Tissue Doppler‐derived atrial dyssynchrony predicts new‐onset atrial fibrillation during hospitalization for ST‐elevation myocardial infarction

2019

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Background Atrial dyssynchrony, but not atrial enlargement/dysfunction, reflects acute atrial histopathological changes. It has been shown to be associated with new‐onset atrial fibrillation (NOAF) in various clinical conditions but was not studied in the acute phase of ST‐elevation myocardial infarction (STEMI) which is the aim of the current study. Methods A total of 440 STEMI patients underwent primary percutaneous coronary intervention (PCI) and were monitored for NOAF during hospitalization. Immediately after primary PCI, P‐wave dispersion was calculated and conventional/tissue Doppler echocardiography was done. Results During a median hospitalization period of 3 days, 80 (18.2%) patients developed NOAF. The group with NOAF showed significantly higher prevalence of hypertension (P = .049), higher P‐wave dispersion (P = .018), higher post–PCI‐corrected TIMI frame count (P < .001), and lower incidence of post‐PCI myocardial blush grade 2–3 (P = .031). Indexed left atrial maximum volume (LAVImax), left atrial dyssynchrony, and inter‐atrial dyssynchrony were significantly higher in NOAF group (P < .001, each). Using ROC curve analysis, inter‐atrial dyssynchrony showed the highest diagnostic performance (AUC 85%, 95% CI: 0.77–0.94, P < .001). A cutoff value at 23.8 ms showed a good validity for predicting NOAF with a sensitivity of 93.8% and a specificity of 68.1%. Using binary logistic regression analysis, history of hypertension (OR = 10.72, P = .03), LAVImax (OR = 7.47, P = .04), and inter‐atrial dyssynchrony (OR = 45.58, P = .001) were independent determinants of NOAF. Conclusions In the acute phase after STEMI, history of hypertension, LAVImax, and inter‐atrial dyssynchrony were independent determinants of inhospital NOAF, with the latter being the strongest.

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“…While clinical studies have reported the usefulness of LAVi in predicting cardiovascular (CV) outcomes in patients with existing coronary artery disease (CAD), most have assessed the prognostic implications in patients following myocardial infarction (MI). [ 9 10 11 12 13 14 ] We assessed LAVi in patients with ACS (STEMI. NSTEMI and US) and studied its role in predicting major adverse cardiac and cerebrovascular (MACCE) outcomes at 30 days.…”

Section: Introductionmentioning

confidence: 99%

Is Indexed Left Atrial Volume (LAVi) in Indian Patients with Acute Coronary Syndrome (ACS) undergoing revascularization a predictor of cardiovascular outcomes?

et al. 2022

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Background: Left atrial volume indexed to body surface area (LAVi) is the recommended method for LA size quantification. Assessing LAVi in Indian patients undergoing coronary interventions for acute coronary syndrome (STEMI, NSTEMI, and UA) is clinically relevant. Methods and Results: Amongst 190 patients (66.4 yrs, 68.4% males), 29.5%, 40.5%, and 30% respectively had STEMI, NSTEMI and UA. Mean LAVi was 32.29 ± 12.06 ml/m 2 and 111 (58.4%) had LAVi ≥32 while 79 (41.6%) had LAVi <32. Patients were divided into 2 groups (group 1 LAVi >32 and group 2 LAVi <32). Group 1 patients had higher prevalence of TVD [ n = 49 vs n = 5, p = <0.001] and higher mean Syntax score (24.47 vs 14.64, p = <0.001). Despite similar LVEF, those with higher LAVi had had higher incidence of mild MR (50.4 vs 27.8, P = 0.0002) and moderate/severe MR was present only in Group 1 patients (27.9% and 5.4%). Grade I, II, and III diastolic dysfunction was present in 71.2, 17.1, and 9.9% patients in Group 1 vs 45.6%, 0%, and 0% in group 2. Diastolic parameters like septal E/e' and lateral E/e'ratio were also higher in Group 1. Major adverse cardiovascular events (MACE) at 30 days was significantly higher in group 1 (20.7 vs 6.3%, P = 0.006). On multivariate analysis, triple vessel disease and LAVi were the only predictors of MACE while LVEF was not. ROC curve analysis for LAVi demonstrated that a cut-off 33.35 ml/m2, predicted 30 day MACE with Area under curve ( AUC) 0.775 (95% CI 0.700-0.850); sensitivity and specificity of 86.7% and 61.4%. Inter-quartile analysis of LAVi (<26.3, 26.3-33.35, 33.36-36.3, and >36.3 ml/m2) demonstrated that 30 day MACE increased across quartiles (4.16%, 4.25%, 22.44%, and 28.26%, respectively, P < 0.001). Conclusion: Amongst patients with ACS undergoing revascularization, those with higher LAVi had more severe CAD, diastolic dysfunction and higher 30 day MACE. LAVi provides superior prognostic information as compared to conventional LV systolic and diastolic parameters in patients with ACS and should be incorporated in routine echocardiographic analysis. More studies with larger numbers and longer follow up are required to further elucidate on this.

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Assessment of the left atrial volume index and plasma NT-proANP level in patients with acute ST-elevation myocardial infarction

Cited by 4 publications

References 37 publications

Correlation of N-terminal fragments of Atrial Natriuretic Neuropeptides (NT-ProANP) with Left Ventricle Ejection Fraction in Cases with Acute Myocardial Infarction

Correlation of N-terminal fragments of Atrial Natriuretic Neuropeptides (NT-ProANP) with Left Ventricle Ejection Fraction in Cases with Acute Myocardial Infarction

Tissue Doppler‐derived atrial dyssynchrony predicts new‐onset atrial fibrillation during hospitalization for ST‐elevation myocardial infarction

Is Indexed Left Atrial Volume (LAVi) in Indian Patients with Acute Coronary Syndrome (ACS) undergoing revascularization a predictor of cardiovascular outcomes?

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