Predictive value of left ventricular dyssynchrony for short-term outcomes in three-vessel disease patients undergoing coronary artery bypass grafting with preserved or mildly reduced left ventricular ejection fraction

Liu, Jia; Fan, Rui; Li, Cuiling; Li, Yanqiu; Liu, Donghong; Li, Wei; Yao, Fengjuan

doi:10.3389/fcvm.2022.1036780

Cited by 3 publications

(2 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 Accordingly, data from 'the Outcome of Discharged HFmrEF Patients study' sugsgested increased risk of cardiovascular death among patients with lower RBC count including 1691 patients with HFmrEF. 36 To the best knowledge of the authors-the present study is the largest that investigated the prognostic impact of anaemia and iron deficiency in patients hospitalized with HFmrEF, while demonstrating its relevant adverse impact on long-term prognosis.…”

Section: Prognostic Impact Of Anaemia In Hfmrefmentioning

confidence: 80%

Effect of anaemia and iron deficiency in heart failure with mildly reduced ejection fraction

Schupp,

Weidner,

Reinhardt

et al. 2024

Eur J Clin Investigation

View full text Add to dashboard Cite

ObjectiveThe present study aims to clarify the prevalence and prognostic impact of anaemia and iron deficiency in patients with heart failure with mildly reduced ejection fraction (HFmrEF).BackgroundThe prognostic impact of anaemia and iron deficiency in HFmrEF has not yet been clarified.MethodsConsecutive patients with HFmrEF were retrospectively included at one institution from 2016 to 2022. Patients with anaemia (i.e. haemoglobin <13 g/dL in males and < 12 g/dL in females) were compared to patients without, respectively patients with or without iron deficiency. The primary endpoint was all‐cause mortality at 30 months (median follow‐up), secondary endpoints comprised HF‐related rehospitalisation.ResultsTwo thousand one hundred and fifty four patients with HFmrEF with a median haemoglobin level of 12.2 g/dL were included. Anaemia was present in 52% of patients with HFmrEF and associated with a higher risk of all‐cause mortality (44% vs. 18%; HR = 3.021; 95% CI 2.552–3.576; p =.001) and HF‐related rehospitalisation (18% vs. 8%; HR = 2.351; 95% CI 1.819–3.040; p =.001) at 30 months, which was confirmed after multivariable adjustment. Although iron status was infrequently assessed in anaemics with HFmrEF (27%), the presence of iron deficiency was associated with higher risk of rehospitalisation for worsening HF (25% vs. 15%; HR = 1.746; 95% CI 1.024–2.976; p =.038), but not all‐cause mortality (p =.279) at 30 months.ConclusionAnaemia and iron deficiency are very common in atleast half of patients with HFmrEF and independently associated with adverse long‐term prognosis.

show abstract

Section: Prognostic Impact Of Anaemia In Hfmrefmentioning

confidence: 80%

Effect of anaemia and iron deficiency in heart failure with mildly reduced ejection fraction

Schupp,

Weidner,

Reinhardt

et al. 2024

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…Було показано, що нормалізація дисинхронії ЛШ після реваскуляризації може допомогти передбачити майбутні великі серцево-судинні події і, отже, бути корисним показником для прогнозування поліпшення прогнозу у пацієнтів з ХКС [13,14]. Також було показано, що ДМ є предиктором подій в короткому періоді спостереження у хворих після аортокоронарного шунтування [15]. Крім того, аналіз Каплана -Майєра виявив значно вищу частоту великих несприятливих серцево-судинних подій у пацієнтів з необструктивною коронарною хворобою серця та ДМ порівняно з хворими без дисинхронії [16].…”

Section: вступunclassified

The relationship between mechanical dyssynchrony of the left ventricular myocardium and the degree of coronary artery occlusion in patients with coronary artery disease

Bilchenko,

Mehtieva,

Bilchenko

2023

ЕМ

View full text Add to dashboard Cite

Background. The prevalence of chronic heart failure in the world is increasing; however, it is stabilizing in developed countries. One of the reasons for this stabilization is an improvement of acute coronary syndrome treatment and revascularization. Revascularization in patients with chronic coronary syndromes without signs of the left ventricular dysfunction is less effective. One of the promising methods for assessing left ventricular dysfunction is the detection of electrical and mechanical dyssynchrony of the myocardium (DM). However, mechanical dyssynchrony of the myocardium has not been sufficiently studied in patients with coronary artery (CA) disease. The purpose was to assess the relationship between mechanical myocardial dyssynchrony and the degree of coronary artery occlusion in patients with coronary artery disease who underwent revascularization. Materials and methods. One hundred and thirty-four patients with coronary artery disease (35 with myocardial infarction and 99 with chronic coronary syndromes) who underwent coronary angiography and revascularization of coronary arteries were included in the study. According to the results of coronary angiography, patients were divided into 3 groups: 12 had unchanged CA (group 1), 17 had atherosclerotic lesions of CA without signs of occlusion (group 2), and 105 patients were with CA occlusion. Among those with CA occlusion, 10 people had an occlusion of less than 50 %, 26 patients had occlusion from 50 to 80 %, 36 had more than 80 %, and 33 patients had complete occlusion of at least one coronary artery. In all patients, parameters of mechanical DM were determined by ultrasound method. Results. In the first group, 3 patients (25 %) had mechanical DM, in the second — 4 patients (23.5 %), in the group with coronary artery occlusion, 42 patients (40 %) had mechanical DM. In the group with complete CA occlusion, mechanical DM was detected in 18 (53 %) cases. Septal to posterior wall motion delay (SPWMD) did not differ significantly in the comparison groups; however, it increased significantly to 64.8 ± 43.2 ms in patients with complete CA occlusion compared with 40.8 ± 13.1 ms in the group with unchanged CA (p < 0.05). SPWMD had a significant correlation with the degree of CA occlusion (r = 0.254, p = 0.009). The interventricular mechanical delay increased significantly, to 61.3 ± 40.5 ms compared with 33.4 ± 3.4 ms in patients with unchanged CA (p < 0.05). Left ventricular filling time was significantly shorter in the group with complete CA occlusion compared to the patients with incomplete CA occlusion and those with unchanged CA (47.3 ± 10.4 ms vs. 54.2 ± 5.7 ms, respectively; p < 0.05). Left ventricular ejection time was not significantly different between comparison groups, but correlated significantly with the degree of CA occlusion (r = 0.241, p = 0.013). The early ventricular time deceleration, the time from the beginning of the QRS complex to the beginning of the peak systolic velocity did not differ significantly. The time to the peak systolic velocity was significantly longer in the group with complete CA occlusion (32.6 ± 8.5 ms), and had a significant correlation with the degree of CA occlusion (r = 0.26, p = 0.007). Conclusions. A third of patients with chronic coronary syndrome included in the study had DM. In the group with complete CA occlusion, the frequency of DM detection increased significantly and was diagnosed in half of cases. In patients with complete CA occlusion, DM manifested itself in a significant SPWMD, an increase in the period of pre-ejection into the aorta and, as a result, a significant increase in the interventricular mechanical delay. An increase in the time to peak systolic velocity was also found in the group of patients with complete CA occlusion. DM associated with left ventricular diastolic dysfunction was detected in a group of patients with complete CA occlusion and manifested itself in a reduced left ventricular filling time.

show abstract

The relationship between mechanical dyssynchrony of the left ventricular myocardium and the number of affected coronary arteries in patients with coronary heart disease who underwent revascularization

Mehtieva,

Bilchenko

2024

The Journal of v. N. Karazin Kharkiv National University, Series "Medicine"

View full text Add to dashboard Cite

Background. A promising method for early detection of myocardial dysfunction is the evaluation of mechanical dyssynchrony of the left ventricular myocardium, the prognostic value of which in the diagnosis of 3-vessel lesions was shown only in a single study and requires further confirmation. Purpose – to assess the relationship between the number of affected coronary arteries and the presence of mechanical dyssynchrony of the myocardium, and its significance in predicting 3-vessel lesions in patients with coronary heart disease. Materials and Methods. 134 patients who underwent coronary angiography with revascularization of coronary arteries were included in the study. Patients were divided into comparison groups depending on the number of affected coronary arteries (without lesions, one, two and three coronary arteries). Variables of mechanical myocardial dyssynchrony were determined for all patients by ultrasound examination of the heart using Doppler examination and synchronization with the ECG. Results. The largest relative number of patients with myocardial dyssynchrony was observed in the group with lesions of 3 coronary arteries – 23 (52%). The presence of myocardial dyssynchrony had a significant correlation with SYNTAX SCORE (r=0.18, p=0.035). The aortic pre-ejection interval in the group of patients with lesions of 3 coronary arteries was significantly longer compared to the group of patients without lesions of the coronary arteries, however, the pulmonary pre-ejection interval was the same in the comparison groups. As a result of this difference, interventricular mechanical delay was significantly greater in the group of patients with occlusion of 3 coronary arteries (54,8±36,6 ms; р=0,043). The time to peak systolic velocity in the group of patients with lesions of 3 coronary arteries was significantly longer (32,1±8,0 ms; р=0,021) compared to the group of patients without atherosclerotic lesions, which was confirmed by a positive correlation (r=0.190, p=0.003). The ROC analysis of the predictive capabilities of the combination of the factors of the presence of myocardial dyssynchrony, left ventricular ejection fraction, interventricular mechanical delay, root mean square deviation of the time to the peak of systolic velocity, and the E/A ratio in relation to lesions of 3 coronary arteries showed sufficient sensitivity (0.89) and specificity (0.87). Conclusions. Patients with lesions to 3 coronary arteries have a significantly higher relative frequency of mechanical myocardial dyssynchrony compared to patients without and lesions of 1 or 2 coronary arteries; correlation of myocardial dyssynchrony with 3-vessel lesions and SYNTAX SCORE was also found. The combination of variables of myocardial dyssynchrony in terms of predicting 3-vessel occlusion of coronary arteries has sufficient sensitivity and specificity.

show abstract

Predictive value of left ventricular dyssynchrony for short-term outcomes in three-vessel disease patients undergoing coronary artery bypass grafting with preserved or mildly reduced left ventricular ejection fraction

Cited by 3 publications

References 39 publications

Effect of anaemia and iron deficiency in heart failure with mildly reduced ejection fraction

Effect of anaemia and iron deficiency in heart failure with mildly reduced ejection fraction

The relationship between mechanical dyssynchrony of the left ventricular myocardium and the degree of coronary artery occlusion in patients with coronary artery disease

The relationship between mechanical dyssynchrony of the left ventricular myocardium and the number of affected coronary arteries in patients with coronary heart disease who underwent revascularization

Contact Info

Product

Resources

About