In-hospital changes of echocardiographic parameters and their relationship with the procollagen I C-terminal propeptide in patients with myocardial infarction and preserved left ventricle systolic function

Abstract

Aim. To study the changes of echocardiographic parameters and their relationship with the procollagen I C-terminal propeptide (PICP) during hospitalization of patients with ST-segment elevation myocardial infarction (STEMI) and preserved left ventricular (LV) systolic function.Material and methods. A total of 120 (100%) patients hospitalized with STEMI were examined. Upon admission, all patients underwent standard examinations to verify myocardial infarction (MI), including coronary angiography and, if necessary, coronary stent implantation. The mean values of LV ejection fraction (LVEF) were 40-49% in 3 patients (2,5%), <40% — in 31 patients (26%), LVEF was. We also analyzed patients with LVEF ≥50%, n=86 (71,6%); mean age was 57,8 years. During the hospitalization, all patients received standard therapy; on the 1st and 12th day of MI, the PICP levels in venous blood serum was determined by enzyme-linked immunosorbent assay. In order to compare PICP values, a control group of healthy volunteers n=20 (100%) was formed, which were comparable by gender and age. In this group, the concentration of PICP was 179,2 [163.5; 194.9] ng/ml.Results. By the 12th day, a significant decrease in the following parameters of the transmitral flow was revealed: DT (p=0,049), dE (0,012), Em (0,029), Em/ Am (p=0,000), Em/PICP (p=0,001). This indicates diastolic function deterioration. At the same time, by the end of hospitalization, systolic function deterioration was recorded in 15,1% of cases. Initially, a higher PICP on the 1st day relative to the control group tended to decrease the concentration by the 12th day, but the differences did not reach statistical significance (p=0,466). Correlation analysis showed a relationship between PICP and echocardiography (Tei index, p=0,026, and mitral annulus velocity, p=0,049).Conclusion. At the hospital stage of treatment of patients with STEMI and preserved LVEF, a negative changes of echocardiography parameters characterizing diastolic dysfunction was revealed. Positive correlation was established between the concentration of PICP with mitral annulus velocity and the Tei index, indicating an association between the myocardial fibrosis and diastolic dysfunction.