Multilayer longitudinal strain can help predict the development of no-reflow in patients with acute coronary syndrome without ST elevation

Atıcı, Adem; Barman, Hasan Ali; Ertürk, Emre; Baycan, Ömer Faruk; Fidan, Serdar; Demirel, Koray; Asoğlu, Ramazan; Demir, Koray; Öztürk, Fatih; Elıtok, Ali; Okuyan, E.; Şahin, İrfan

doi:10.1007/s10554-019-01623-8

Cited by 6 publications

(2 citation statements)

References 46 publications

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“…Myocardial injury due to ischemic heart disease spreads from the endocardium towards epicardium [ 27 ]. According to Atıcı et al in patients with the phenomenon of no-reflow after PCI multilayer strain imaging revealed lower strain values particularly in endocardial layer [ 32 ]. Non-invasive diagnostics including speckle tracking echocardiography may constitute a new starting point for consideration about separation the myocarditis group without additional imaging in patients with an initial diagnosis of STEMI on admission at which the obstructive CAD had been excluded.…”

Section: Discussionmentioning

confidence: 99%

Acute coronary syndrome versus acute myocarditis in young adults–value of speckle tracking echocardiography

et al. 2022

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Purpose Comparing myocarditis with an acute coronary syndrome (ACS)-like presentation and acute myocardial infarction (AMI) poses an important clinical challenge. The purpose of the study was to investigate the diagnostic value of the clinical, laboratory and especially echocardiographic characteristics including speckle tracking echocardiography (STE) of patients with ACS-like myocarditis and AMI. Methods We conducted a retrospective analysis comparing 69 symptomatic patients (≤ 45 years old), hospitalized at the Department of Interventional Cardiology (Medical University of Lodz, Poland) between April 2014 and June 2021 with an initial diagnosis of ST-segment elevation myocardial infarction. Results 37 patients with the cardiac magnetic resonance–confirmed acute myocarditis and 32 patients diagnosed with AMI based on the clinical presentation, electrocardiogram and the presence of a culprit lesion on the coronary angiography were analysed including echocardiography parameters. On STE analysis an average global longitudinal (GLS), radial and circumferential strain including three—layers observation were significantly lower (absolute value) in patients with AMI versus acute myocarditis (p<0.05). There was no significant difference in Endo/Epi ratio (p = 0.144) between the groups. An average GLS < (-17.5) represented the optimal cut-off value for the myocarditis diagnosis. Conclusion In patients with AMI a significant reduction of global and three-layers strains compared to patients with myocarditis was detected. Furthermore, our analysis also confirmed the discriminative pattern of myocardial injury between the groups.

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Section: Discussionmentioning

confidence: 99%

Acute coronary syndrome versus acute myocarditis in young adults–value of speckle tracking echocardiography

et al. 2022

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“…Coronary artery obstruction in STEMI requires urgent revascularization, but the clinical presentation of patients with NSTE-ACS is much more variable, and about one-third of patients with NSTE-ACS do not necessarily have coronary artery obstruction or severe coronary lesions, and these patients do not require revascularization. Therefore, it is more important for clinicians to accurately select patients who really need coronary angiography for revascularization to reduce the complications related with the operation and also reduce the medical costs during the treatment process [ 1 ]. Two-dimensional speckle tracking echocardiography (2D-STE) allows quantitative evaluation of the myocardial strain to assess cardiac function and has been considered an accurate indicator of overall and local cardiac function [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Application of Layered Strain Technique in NSTE-ACS

Zhao

Zhang

et al. 2022

Cardiovascular Therapeutics

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Background. To explore the application value of layered strain technique in non-ST elevation acute coronary syndrome (NSTE-ACS). Methods. 120 patients with suspected NSTE-ACS undergoing coronary angiography in our hospital from December 2018 to December 2019 were prospectively selected. According to the results of coronary angiography, the patients were divided into the significant CAD group and the nonsignificant CAD group. Echocardiography was performed 1-2 hours before invasive coronary angiography. The long axis and circumferential strain of the endocardium, myocardial layer, and epicardium were evaluated by the layered strain technique. The territorial longitudinal strain (TLS), the global longitudinal strain (GLS) of the three myocardial layers, and the global circumferential strain (GCS) were calculated based on the perfusion region of the three coronary arteries and the 17-segment model of the left ventricle. The primary endopoints were TLS and GCS of the three-layer myocardium. Results. Compared with the nonsignificant CAD patients, the TLS and GCS of three-layer myocardium in significant CAD patients were decreased, especially in the endocardium. The absolute values of TLS and GCS of the endocardium and epicardium in significant CAD patients were lower than those in nonsignificant CAD patients. This indicates a significant decrease in endocardial function. Receiver operating characteristic (ROC) curve analysis showed that endocardial TLS was superior to LVEF, Troponin I (TnI), and other strain parameters in evaluating the extent of coronary lesions. Conclusions. The layered strain technique of 2D-STE can evaluate the severity of coronary lesions in patients with NSTE-ACS, and for significant CAD patients, endocardial function is significantly more impaired than epicardial function.

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Anti-inflammatory effects of proprotein convertase subtilisin/kexin 9 inhibitor therapy in the early phase of acute myocardial infarction

Shimizu,

Morishita,

Uzui

et al. 2024

Heart Vessels

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This study examined the anti-inflammatory and endothelial function-enhancing effects of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitor therapy in the early phase after acute myocardial infarction (AMI) by assessing changes in tumor necrosis factor-α (TNF-α) levels and the l-arginine/asymmetric-dimethylarginine (ADMA) ratio. This retrospective, single-center cohort study included patients who underwent successful timely primary percutaneous coronary intervention (PCI) for first-onset AMI between September 2017 and March 2018. The PCSK9 inhibitor group comprised patients who received 75 mg alirocumab up to 7 days after AMI, while the standard therapy group comprised patients who did not. We evaluated the change in TNF-α levels and the l-arginine/ADMA ratio at the time of hospital admission and prior to discharge. PCSK9 inhibitor therapy in the early phase after AMI suppressed TNF-α levels (standard therapy group, 1.64 ± 2.14 pg/mL vs. PCSK9 inhibitor group, 0.26 ± 0.33 pg/mL; p = 0.033) and increased the L-arginine/ADMA ratio (standard therapy group, − 13.0 ± 39.7 vs. PCSK9 inhibitor group, 23.2 ± 39.7; p = 0.042). Upon multiple regression analysis adjusted for sex, age, and peak creatine kinase levels, PCSK9 inhibitor therapy was associated with TNF-α suppression (p = 0.025; β = − 0.235, 95% confidence interval [CI], − 0.436 to − 0.033). The L-arginine/ADMA ratio was also analyzed using multiple regression, adjusted for sex, age, peak creatine kinase levels, and smoking, showing a significant improvement in the ratio (p = 0.018; β = 41.913, 95% CI, 10.337−73.491). Moreover, a weak negative correlation was suggested between the change in TNF-α levels and the change in l-arginine/ADMA ratio (r = − 0.393, p = 0.058). PCSK9 inhibitor therapy in the early phase after AMI suppresses TNF-α levels and improves the l-arginine/ADMA ratio, potentially indicating anti-inflammatory and endothelial function-enhancing effects.

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Multilayer longitudinal strain can help predict the development of no-reflow in patients with acute coronary syndrome without ST elevation

Cited by 6 publications

References 46 publications

Acute coronary syndrome versus acute myocarditis in young adults–value of speckle tracking echocardiography

Acute coronary syndrome versus acute myocarditis in young adults–value of speckle tracking echocardiography

Application of Layered Strain Technique in NSTE-ACS

Anti-inflammatory effects of proprotein convertase subtilisin/kexin 9 inhibitor therapy in the early phase of acute myocardial infarction

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