Single-Point Troponin T Measurement On The Day Of Coronary Care Unit Discharge After Myocardial Infarction Strongly Correlates With Ejection Fraction And Infarct Size By Nuclear Imaging And With CK-MB Release

2004 ◽  
pp. 97-107
Author(s):  
G. Bonetti ◽  
F. Pagani ◽  
R. Giubbini ◽  
C. Cuccia ◽  
M. Panteghini
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Infarct Size ◽  
Coronary Care Unit ◽  
Troponin T ◽  
Single Point ◽  
Nuclear Imaging ◽  
Unit Discharge ◽  
Coronary Care

scholarly journals Single-Point Cardiac Troponin T at Coronary Care Unit Discharge after Myocardial Infarction Correlates with Infarct Size and Ejection Fraction

2002 ◽  
Vol 48 (9) ◽  
pp. 1432-1436 ◽  
Author(s):  
Mauro Panteghini ◽  
Claudio Cuccia ◽  
Graziella Bonetti ◽  
Raffaele Giubbini ◽  
Franca Pagani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Infarct Size ◽  
Cardiac Troponin ◽  
Coronary Care Unit ◽  
Troponin T ◽  
Left Ventricular ◽  
Lv Function ◽  
Cardiac Troponin T ◽  
Coronary Care

Abstract Background: One of the major concerns in replacing creatine kinase MB (CK-MB) with cardiac troponins is the lack of evidence of the ability of troponins to estimate the size of acute myocardial infarction (AMI). We investigated the ability of a single measurement of cardiac troponin T (cTnT) at coronary care unit (CCU) discharge to estimate infarct size and assess left ventricular (LV) function in AMI patients. Methods: We studied 65 AMI patients in whom infarct size was estimated by CK-MB peak concentrations and gated single-photon emission computed tomography (SPECT) myocardial perfusion using technetium-99m sestamibi and LV function by SPECT imaging. Measurements of cTnT and SPECT were performed 72 h (median) after admission (range, 40–160 h). SPECT was also repeated 3 months later. Results: We found a significant correlation between cTnT and both the peak CK-MB concentrations (r = 0.76; P <0.001) and the perfusion defect size at SPECT (r = 0.62; P <0.001). cTnT was inversely related to LV ejection fraction (LVEF) assessed both early (r = −0.56; P <0.001) and 3 months after AMI (r = −0.70; P <0.001). cTnT >2.98 μg/L predicted a LVEF <40% at 3 months with a sensitivity of 86.7%, specificity of 81.4%, and a likelihood ratio for a positive test of 4.7 (95% confidence interval, 4.0–5.4). Conclusions: A single cTnT measurement at CCU discharge after AMI is useful as a noninvasive estimate of infarct size and for the assessment of LV function in routine clinical setting.

Management of Ventricular Fibrillation during Acute Myocardial Infarction

1984 ◽  
Vol 23 (04) ◽  
pp. 209-213
Author(s):  
B. J. Northover
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Fibrillation ◽  
Coronary Care Unit ◽  
Patient Survival ◽  
Left Ventricular ◽  
Ventricular Failure ◽  
Before And After ◽  
Coronary Care ◽  
The Creation

SummaryAnalysis of electrocardiograms tape-recorded from patients admitted to hospital with acute myocardial infarction revealed that the pattern of ventricular extrasystolic activity was not significantly different among those who subsequently developed ventricular fibrillation and those who did not. Episodes of ventricular fibrillation occurred predominantly within 4 hours from the start of infarction. Patients were 3 times less likely to survive an episode of ventricular fibrillation if they also had left ventricular failure than if this feature was absent. Management of episodes of ventricular fibrillation was compared in patients before and after the creation of a specially staffed and equipped coronary care unit. The success of electric shock as a treatment for ventricular fibrillation was similar before and after the creation of the coronary care unit. An attempt was made to determine which features in the management of ventricular fibrillation in this and in previously published series were associated with patient survival.

Implication of anti-angiogenic VEGF-A165b in angiogenesis and systolic function after reperfused myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Marcos Garces ◽  
C Rios-Navarro ◽  
L Hueso ◽  
A Diaz ◽  
C Bonanad ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Adjuvant Therapy ◽  
Ejection Fraction ◽  
Infarct Size ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Coronary Reperfusion ◽  
Ventricular Ejection Fraction

Abstract Background Angiogenesis participates in re-establishing microcirculation after myocardial infarction (MI). Purpose In this study, we aim to further understand the role of the anti-angiogenic isoform vascular endothelial growth factor (VEGF)-A165b after MI and explore its potential as a co-adjuvant therapy to coronary reperfusion. Methods Two mice MI models were formed: 1) permanent coronary ligation (non-reperfused MI), 2) transient 45-min coronary occlusion followed by reperfusion (reperfused MI); in both models, animals underwent echocardiography before euthanasia at day 21 after MI induction. Serum and myocardial VEGF-A165b levels were determined. In both experimental MI models, functional and structural implication of VEGF-A165b blockade was assessed. In a cohort of 104 ST-segment elevation MI patients, circulating VEGF-A165b levels were correlated with cardiovascular magnetic resonance-derived left ventricular ejection fraction at 6-months and with the occurrence of adverse events (death, heart failure and/or re-infarction). Results In both models, circulating and myocardial VEGF-A165b presence was increased 21 days after MI induction. Serum VEGF-A165b levels inversely correlated with systolic function evaluated by echocardiography. VEGF-A165b blockage increased capillary density, reduced infarct size, and enhanced left ventricular function in reperfused, but not in non-reperfused MI experiments. In patients, higher VEGF-A165b levels correlated with depressed ejection fraction and worse outcomes. Conclusions In experimental and clinical studies, higher serum VEGF-A165b levels associates with a worse systolic function. Its blockage enhances neoangiogenesis, reduces infarct size, and increases ejection fraction in reperfused, but not in non-reperfused MI experiments. Therefore, VEGF-A165b neutralization represents a potential co-adjuvant therapy to coronary reperfusion. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” (Exp. PIE15/00013, PI17/01836, PI18/00209 and CIBERCV16/11/00486).

M-Complex: The Electrocardiographic Sign of Impending Cardiac Rupture following Myocardial Infarction

1972 ◽  
Vol 17 (10) ◽  
pp. 319-325 ◽  
Author(s):  
M. Afzal Mir
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Coronary Care Unit ◽  
Progressive Increase ◽  
Injury Pattern ◽  
Cardiac Rupture ◽  
Time Of Death ◽  
St Segment ◽  
Coronary Care ◽  
Electrocardiogram Ecg

Out of 284 patients admitted to the Coronary-Care Unit, 60 patients showed an acute monophasic injury pattern (M-Complex) on their initial electrocardiogram (ECG). There were 13 fatalities on the first day of myocardial infarction; 6 from the M-complex group. Three of these 6 patients died with cardiac rupture. The ECG features of these 3 patients were compared with the 3 non-rupture patients. A progressive increase in the elevated R-ST segment of the M-complex with an upward ‘pull’ of the R-ST junction, proved to be an ominous ECG sign of impending cardiac rupture in patients with protracted chest pain and persistent hypertenison. The 3 non-rupture patients remained in a hypotensive state from admission to the time of death. Atrioventricular block and A-V junctional tachycardia were the commonest rhythm disturbances in patients dying with cardiac rupture.

scholarly journals Correlation of ejection fraction and infarct size estimated from the total CK released in patients with acute myocardial infarction.

Heart ◽  
1979 ◽  
Vol 41 (4) ◽  
pp. 433-440 ◽  
Author(s):  
M Hori ◽  
M Inoue ◽  
S Fukui ◽  
T Shimazu ◽  
M Mishima ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ejection Fraction ◽  
Infarct Size

The Reduction of Cardiac Patients in the Coronary Care Unit of the Santa Izabel Hospital During the COVID-19 Pandemic

2021 ◽  
Vol 4 (3/4) ◽  
pp. 131-134
Author(s):  
Gilson Feitosa ◽  
Leandro Cavalcanti ◽  
Amanda Fraga ◽  
Milana Prado ◽  
Gilson Feitosa Filho ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Coronary Care Unit ◽  
Myocardial Revascularization ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
The World ◽  
St Elevation ◽  
Coronary Care

The coronary care unit by Santa Izabel Hospital (Salvador, Bahia, Brazil) made a comparison of admitted patients with coronary disease cases admitted between two equivalent periods ranging from April through July in 2019 and 2020. There was a striking reduction in 2020 of cases of ST-elevation myocardial infarction (39%); non-ST elevation myocardial infarction (19%); and unstable angina pectoris (21%). This occurred in parallel with what happened in many parts of the world and hampered offering the best treatment strategy to these patients with an acute coronary syndrome such as invasive stratification and myocardial revascularization.  

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