Review: Heart failure complicating acute myocardial infarction in patients with diabetes: pathophysiology and management strategies

Sulfi, Sreekumar

doi:10.1177/14746514060060050201

Cited by 2 publications

(1 citation statement)

References 57 publications

(62 reference statements)

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“…12,13 Other than advanced age, smoking is the single most important risk factor for coronary artery disease and has a major impact on myocardial infarction and all-cause mortality. Beyond acute unfavorable effects on blood pressure and sympathetic tone, and a reduction in myocardial oxygen supply; smoking affects atherothrombosis through several other mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of the impact of cardiovascular risk factors on left ventricular systolic function in patients with acute myocardial infarction

et al. 2014

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Background: Objectives of current study were to determine the magnitude of left ventricular systolic dysfunction in patients with acute myocardial infarction in the rural sub-population of Uttar Pradesh in India and to evaluate the impact of cardiovascular risk factors on the risk of impairment of left ventricular systolic function. Methods: One hundred and fifty seven consecutive patients with first acute myocardial infarction were enrolled into the study. Most patients were male (73.2%) and the mean age of presentation was 52.7 years. Two dimensional echocardiography was utilized to assess conventional parameters such as Left Ventricular End-Diastolic Diameter (LVEDD), Left Ventricular End-Systolic Diameter (LVESD), LV End-Diastolic Volume (LVEDV), LV End-Systolic Volume (LVESV) and Left Ventricular Ejection Fraction (LVEF). The LV volumes (end-systolic and end-diastolic) and LVEF were calculated from the conventional apical two-and four-chamber images using the biplane Simpson's technique. LV systolic function was considered depressed when LVEF was less than 45%. The chi-square test was used in the statistical analysis to compare proportions and a logistic regression model was used to assess the independent effect of the each variable. Results: The study projects a high proportion (42.7% of the patient population) of left ventricular systolic dysfunction in patients with Acute Myocardial Infarction (AMI). No association was found between gender or age and LV systolic dysfunction. The proportion of patients with diabetes mellitus was higher in the sub-group of patients with impaired LV systolic function (45.2% vs. 30.2%, P = 0.01); the proportion of patients with history of current or past smoking was also higher in the sub-group of patients with impaired LV systolic function (48.9% vs. 34.2%, P = 0.03). On the other hand, hypertension and dyslipidemia were not associated with impaired LVEF. After adjustment of other variables, diabetes and smoking were associated with a significantly higher risk of LV systolic dysfunction (diabetes: OR = 3.73; 95% CI = 1.25-11.16; smoking: OR = 3.8; 95% CI = 1.37-11.05). Conclusion: Since the proportion of patients with LV systolic dysfunction in patients with AMI remains relatively high, LV systolic function variables such as LVEF and LVESV should be echocardiographically evaluated in all patients with AMI. Since the post-infarction LV systolic function remains the single most important determinant of survival, treatment of AMI patients should be aimed at limitation of infarct size and prevention of ventricular dilation. Moreover, cardiovascular risk factors such as diabetes mellitus and smoking have a significant impact on the likelihood of impairment of LV systolic function in patients with AMI and hence could influence long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of the impact of cardiovascular risk factors on left ventricular systolic function in patients with acute myocardial infarction

et al. 2014

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The Impact of Acute Myocardial Infarction on Left Ventricular Systolic Function

Koçinaj

Bakalli²,

Gashi³

et al. 2011

Med Arh

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B ackground. During acute myocardial infarction left ventricular systolic function is an important prognostic factor whose worsening is still frequent despite the therapeutic approach. We aimed to estimate the incidence of left ventricular systolic dysfunction among patients experiencing acute myocardial infarction. Methods. The study involved 154 consecutive patients admitted at Coronary Care Unit. The study design was based upon the collection of patient histories, clinical examination and other complementary tests. Results. In overall study population, predominantly with male gender, the incidence of left ventricle systolic dysfunction was 42.3%, which correlated with myocardial damage, electrocardiography changes, myocardial enzymes, and myocardial wall motion. Conclusions. Transthoracic Echocardiography represents a valuable tool and left ventricular ejection fraction should be evaluated in all patients experiencing acute myocardial infarction since the incidence of left ventricular dysfunction in patients with Acute Myocardial Infarction remains relatively high.

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Review: Heart failure complicating acute myocardial infarction in patients with diabetes: pathophysiology and management strategies

Cited by 2 publications

References 57 publications

Echocardiographic assessment of the impact of cardiovascular risk factors on left ventricular systolic function in patients with acute myocardial infarction

Echocardiographic assessment of the impact of cardiovascular risk factors on left ventricular systolic function in patients with acute myocardial infarction

The Impact of Acute Myocardial Infarction on Left Ventricular Systolic Function

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