Incremental Prognostic Value of Novel Left Ventricular Diastolic Indexes for Prediction of Clinical Outcome in Patients With ST-Elevation Myocardial Infarction

Shanks, Miriam; Ng, Arnold C.T.; Veire, Nico R. L. Van de; Antoni, M. Louisa; Bertini, Matteo; Delgado, Victoria; Nucifora, Gaetano; Holman, Eduard R.; Choy, Jonathan B.; Leung, Dominic Y.; Schalij, Martin J.; Bax, Jeroen J.

doi:10.1016/j.amjcard.2009.10.039

Cited by 50 publications

(24 citation statements)

References 29 publications

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“…Peak early diastolic myocardial velocities (EЈ) were measured in the basal septal mitral annulus, and the ratio of peak transmitral E wave/septal EЈ was calculated (septal E/eЈ ratio). 20 …”

Section: Evaluation Of Myocardial Diastolic Functionmentioning

confidence: 99%

“…20 Color-coded tissue Doppler images of the left ventricle were obtained in apical 4-chamber view acquired at the highest possible frame rates (Ͼ150 frames/s) during end expiration and stored for off-line analysis. Peak early diastolic myocardial velocities (EЈ) were measured in the basal septal mitral annulus, and the ratio of peak transmitral E wave/septal EЈ was calculated (septal E/eЈ ratio).…”

Section: Evaluation Of Myocardial Diastolic Functionmentioning

confidence: 99%

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Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T ₁ Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients

Auger²,

Delgado³

et al. 2012

Circ: Cardiovascular Imaging

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121

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Background-Diabetic patients have increased interstitial myocardial fibrosis on histological examination. Magnetic resonance imaging (MRI) T 1 mapping is a previously validated imaging technique that can quantify the burden of global and regional interstitial fibrosis. However, the association between MRI T 1 mapping and subtle left ventricular (LV) dysfunction in diabetic patients is unknown. Methods and Results-Fifty diabetic patients with normal LV ejection fraction (EF) and no underlying coronary artery disease or regional macroscopic scar on MRI delayed enhancement were prospectively recruited. Diabetic patients were compared with 19 healthy controls who were frequency matched in age, sex and body mass index. There were no significant differences in mean LV end-diastolic volume index, end-systolic volume index and LVEF between diabetic patients and healthy controls. Diabetic patients had significantly shorter global contrast-enhanced myocardial T 1 time (425Ϯ72 ms vs. 504Ϯ34 ms, PϽ0.001). There was no correlation between global contrast-enhanced myocardial T 1 time and LVEF (rϭ0.14, Pϭ0.32) in the diabetic patients. However, there was good correlation between global contrast-enhanced myocardial T 1 time and global longitudinal strain (rϭϪ0.73, PϽ0.001). Global contrast-enhanced myocardial T 1 time was the strongest independent determinant of global longitudinal strain on multivariate analysis (standardized ␤ϭϪ0.626, PϽ0.001). Similarly, there was good correlation between global contrast-enhanced myocardial T 1 time and septal EЈ (rϭ0.54, PϽ0.001). Global contrast-enhanced myocardial T 1 time was also the strongest independent determinant of septal EЈ (standardized ␤ϭ0.432, PϽ0.001). Conclusions-A shorter global contrast-enhanced myocardial T 1 time was associated with more impaired longitudinal myocardial systolic and diastolic function in diabetic patients. (Circ Cardiovasc Imaging. 2012;5:51-59.)

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Section: Evaluation Of Myocardial Diastolic Functionmentioning

confidence: 99%

Section: Evaluation Of Myocardial Diastolic Functionmentioning

confidence: 99%

Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T ₁ Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients

Auger²,

Delgado³

et al. 2012

Circ: Cardiovascular Imaging

Self Cite

121

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“…53 Global SR IVR by STE provided incremental information over baseline clinical, angiographic, and other echocardiographic variables (including ejection fraction and TD velocities). Patients with SR IVR Յ0.24 s Ϫ1 had a significantly higher event rate than those with a higher SR IVR .…”

Section: Oh Et Almentioning

confidence: 99%

Established and Novel Clinical Applications of Diastolic Function Assessment by Echocardiography

Park

Nagueh

2011

Circ: Cardiovascular Imaging

135

120

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A cardiac cycle consists of systolic (contraction) and diastolic (relaxation and filling) phases that are linked closely together for optimal function of the heart. Normal diastolic function allows adequate filling of the heart without an excessive increase in diastolic filling pressure both in the resting state and with stress or exertion. 1 The diastolic phase is remarkably well designed to ensure that the ventricle is optimally filled for a given clinical condition. 2 Basically, at the end of systole, left ventricular (LV) relaxation begins as an initial diastolic process, and LV pressure falls rapidly as the LV expands. This relaxation phase is accompanied by active movement of the mitral annulus away from the apex. The velocity of LV dilatation and mitral annular movement during early diastole correlates well with how fast the LV fills and relaxes, respectively. 3,4 Myocardial relaxation continues during early diastole to reach the minimal LV diastolic pressure, which helps with "sucking" or "pulling" the blood actively into the LV (Figure 1, online-only Data Supplement Video 1A). The minimal LV diastolic pressure or completion of relaxation normally occurs by 3.5 times the value of tau-the time constant of relaxation (normal Ͻ45 ms)-after the mitral opening. 5 LV pressure then rises to be equilibrated with left atrial (LA) pressure, at which time the early diastolic filling decelerates to close the mitral valve until the time of atrial contraction when LA pressure increases to initiate the late filling to complete diastole ( Figure 1, online-only Data Supplement Video 1B).In the healthy young heart, early diastole is responsible for the majority of ventricular filling, providing a good diastolic reserve. As myocardial relaxation becomes less active with aging or abnormally delayed due to a disease process, the rate of LV pressure decline during the early diastole is reduced, and it takes a longer time to reach the minimal LV diastolic pressure. The rate of LV dilatation during early diastole is reduced, and both elongation of the LV and mitral annular motion are reduced (Figure 1), resulting in reduced diastolic filling and a longer time to reach equilibration of LV-LA pressure. Under this circumstance, atrial contraction is responsible for a substantial proportion of diastolic filling. As long as all the necessary filling can be completed through this mechanism with intact atrial contraction and an adequate diastolic filling period, the mean LA pressure remains normal, although it may be increased at the end of diastole if LA compliance is decreased.A major problem with delayed relaxation, however, is a reduced diastolic reserve. Healthy individuals with normal relaxation are able to increase the rate of myocardial relaxation when there is a need for increased diastolic filling. Faster relaxation allows the achievement of a lower minimal LV diastolic pressure at a shorter time interval than in the resting state. Hence, increased LV filling can occur even with a shortened diastolic filling time. When myoca...

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“…Previous studies have demonstrated the long-term prognostic relevance of strain echocardiography after AMI [21][22][23][24][25][26][27][28][29]. However, the short-term prognostic value of strain echocardiography in patients with STEMI has not been well evaluated.…”

Section: Introductionmentioning

confidence: 98%

Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI

Khuyag¹,

Chimed²,

Baldandorj³

et al. 2017

Cent. Asian j. Med. Sci.

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Objectives: Left ventricular (LV) systolic function is major predictor of outcome after acute myocardial infarction (AMI). In recent years, speckle-tracking echocardiography (STE) derived strain measurement has been demonstrated to directly reflect myocardial deformation patterns and to be superior to conventional echocardiographic measurements. Our study aimed to reveal the prognostic value of strain parameters for 30-day mortality in patients with ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). Methods: We prospectively included patients with STEMI after primary PCI treatment. The primary endpoint was 30-day mortality. 2D STE was used to determine LV strain parameters. Results: 414 patients were selected. 30-day mortality occurred in 15 patients (3.6%). LV global longitudinal strain (GLS) was significantly impaired in the 30-day mortality group compared with survivors (-8.0±2.6% vs. -15.4±3.8%, p<0.001). Multivariate regression revealed that LV GLS was independently associated with 30-day mortality (OR 1.71, 95% CI 1.23-2.38, p<0.001). Adding GLS into the clinical and echocardiographic model improved model performance. Conclusion:The LV GLS parameter is an independent predictor of 30-day mortality in patients with STEMI after primary PCI treatment. Adding LV GLS into the prediction model improved its predictive performance.

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Incremental Prognostic Value of Novel Left Ventricular Diastolic Indexes for Prediction of Clinical Outcome in Patients With ST-Elevation Myocardial Infarction

Cited by 50 publications

References 29 publications

Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T ₁ Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients

Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T ₁ Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients

Established and Novel Clinical Applications of Diastolic Function Assessment by Echocardiography

Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI

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Incremental Prognostic Value of Novel Left Ventricular Diastolic Indexes for Prediction of Clinical Outcome in Patients With ST-Elevation Myocardial Infarction

Cited by 50 publications

References 29 publications

Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T 1 Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients

Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T 1 Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients

Established and Novel Clinical Applications of Diastolic Function Assessment by Echocardiography

Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI

Contact Info

Product

Resources

About

Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T ₁ Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients

Association Between Diffuse Myocardial Fibrosis by Cardiac Magnetic Resonance Contrast-Enhanced T ₁ Mapping and Subclinical Myocardial Dysfunction in Diabetic Patients