Russian Heart Failure Journal 2014year Effects of left and right ventricular diastolic function parameters on one-year prognosis of patients after primary transcutaneous intervention for ST elevation myocardial infarction


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2014/№1

Effects of left and right ventricular diastolic function parameters on one-year prognosis of patients after primary transcutaneous intervention for ST elevation myocardial infarction

Sumin A. N., Galimzyanov D. M., Sergeeva T. Yu., Barbarash O. L.

Keywords: diastolic dysfunction of the left ventricle, diastolic dysfunction of the right ventricle, myocardial infarction, prognosis, transcutaneous coronary intervention

DOI: 10.18087/rhfj.2014.1.1895

Background. Log-term prognosis for patients who have had ST elevation myocardial infarction (STEMI) is determined by both clinical factors and parameters of LV systolic and diastolic function. In patients with STEMI, primary transcutaneous intervention (TCI) significantly improves both the response to hospital treatment and the remote outcome, which may change relative contributions of various predictive factors. Aim. To evaluate the predictive value of RV and LV diastolic function and other clinical and EchoCG parameters following a primary TCI in patients with STEMI. Materials and methods. The study included 79 patients with STEMI after a primary TCI with stenting of the infarct-related artery. EchoCG was recorded at 1 and 12 days of disease with evaluation of ventricular systolic and diastolic function. Over one year, one patient had a fatal outcome, 15 patients had recurrent MI, 3 patients had stroke, and 11 patients had repeated revascularization. 46 patients did not and 23 patients had cardiovascular events. These groups of patients were compared by clinical and historical data, laboratory data, and parameters of intracardiac hemodynamics at 1 and 12 days of disease. Results. The groups differed in duration of arterial hypertension (AH) (р=0.042) and presence of multi-vessel coronary disease (р=0.034). At 12 days, the group of unfavorable prognosis had increased Еm / еm ratio (р=0.051), reduced еm (р=0.084), and increased RV isovolumetric relaxation time (IRT) (р=0.0039). The following factors correlated with the unfavorable prognosis: smoking (р=0.040), AH duration (р=0.024), multi-vessel coronary artery disease (р=0.035), and changes in the Em deceleration time (DT) during the hospital treatment (р=0.009). Multifactorial analysis showed that only Em DT correlated with the unfavorable prognosis (р=0.038). Conclusion. The one-year unfavorable prognosis in patients with STEMI correlated with the number of affected coronary arteries, AH duration, and changes in Em DT during the hospital treatment. Primary TCI not only improved the one-year prognosis in patients with STEMI but also moderated the predictive value of EchoCG parameters in these patients.
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Sumin A. N., Galimzyanov D. M., Sergeeva T. Yu. et al. Effects of left and right ventricular diastolic function parameters on one-year prognosis of patients after primary transcutaneous intervention for ST elevation myocardial infarction. Russian Heart Failure Journal. 2014;15(1):14–22.

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