scholarly journals P1769 Levels of serum markers of myocardial injury in patients with ST-elevation myocardial infarction correlate with global left ventricular longitudinal deformation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Szymczyk ◽  
P Lipiec ◽  
B Michalski ◽  
J D Kasprzak

Abstract The aim of this study was to assess the correlation of levels of serum markers of myocardial injury with parameters of myocardial function assessed by 2D-speckle tracking echocardiography in patients with ST-elevation myocardial infarction (STEMI) Material and methods. The study group comprised 96 patients (69 male, mean age 58 ± 10 years) with first STEMI treated with successful primary percutaneous coronary intervention. Levels of serum markers of myocardial injury (troponin T and CKMB mass) were assessed on admission and then monitored during the hospitalization. 7-12 days after STEMI, all patients underwent resting 2D echocardiography with subsequent offline analysis using 2D speckle tracking algorithm. Measurements of left ventricular deformation included peak systolic longitudinal and transverse strain (SLS and STS) – maximal value before aortic valve closure, peak longitudinal and transverse strain (PLS and PTS) – including possible postsystolic contraction, systolic longitudinal and transverse strain rate (SLSR and STSR) at baseline. Results On admission median values (I – III quartile) of CKMB mass and troponin T were 20,0 ng/ml (6,3 – 59,0; range 1,9 – 475,3) and 0,25 ng/ml (0,06 – 1,04; range 0,01 – 11,2), respectively. Maximal values (I – III quartile) of CKMB mass and troponin T were 94,1 (28,0 – 215,7; range 3,2 – 500) and 3,29 (1,6 – 6,3; range 0,42 – 17,2), respectively. Statistically significant correlations were observed for the global values of the longitudinal strain parameters and the concentration of troponin T and CKMB mass (rs from 0.22 to 0.36). The strongest correlations were noted for the maximum serum level of troponin T. Among the best strain parameters was the global systolic longitudinal deflection (SLS). There was no statistically significant correlation between the parameters of transverse deformation and the concentrations of markers for myocardial necrosis. Conclusions Troponin T correlates with global left ventricular longitudinal deformation in patients with ST-elevation myocardial infarction.

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0173034 ◽  
Author(s):  
Christian Shetelig ◽  
Shanmuganathan Limalanathan ◽  
Jan Eritsland ◽  
Pavel Hoffmann ◽  
Ingebjørg Seljeflot ◽  
...  

2021 ◽  
Vol 10 (13) ◽  
pp. 2968
Author(s):  
Alessandro Bellis ◽  
Giuseppe Di Gioia ◽  
Ciro Mauro ◽  
Costantino Mancusi ◽  
Emanuele Barbato ◽  
...  

The significant reduction in ‘ischemic time’ through capillary diffusion of primary percutaneous intervention (pPCI) has rendered myocardial-ischemia reperfusion injury (MIRI) prevention a major issue in order to improve the prognosis of ST elevation myocardial infarction (STEMI) patients. In fact, while the ischemic damage increases with the severity and the duration of blood flow reduction, reperfusion injury reaches its maximum with a moderate amount of ischemic injury. MIRI leads to the development of post-STEMI left ventricular remodeling (post-STEMI LVR), thereby increasing the risk of arrhythmias and heart failure. Single pharmacological and mechanical interventions have shown some benefits, but have not satisfactorily reduced mortality. Therefore, a multitarget therapeutic strategy is needed, but no univocal indications have come from the clinical trials performed so far. On the basis of the results of the consistent clinical studies analyzed in this review, we try to design a randomized clinical trial aimed at evaluating the effects of a reasoned multitarget therapeutic strategy on the prevention of post-STEMI LVR. In fact, we believe that the correct timing of pharmacological and mechanical intervention application, according to their specific ability to interfere with survival pathways, may significantly reduce the incidence of post-STEMI LVR and thus improve patient prognosis.


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