scholarly journals The evaluation of in-hospital prognosis of patient with myocardial infarction and atrial fibrillation

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
I Leonova ◽  
M Solovyeva ◽  
S Boldueva
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Left Ventricular ◽  
Main Group ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Minor Bleeding ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients

Abstract Funding Acknowledgements Type of funding sources: None. Purpose  to assess the incidence of various forms of atrial fibrillation (AF) among the patients with MI, the prevalence of various types of myocardial infarction (MI) among the patients with AF, the features of the in-hospital prognosis among the patients with MI, and AF compared with those without AF. Materials and methods  1660 cases of patients with MI treated in 2013-18 - the main group (100 patients) were analyzed.  Results  AF occurred in 309 patients (18.6% of the total number of patients with MI). Preexisting AF was in 59.2% of patients. Patients with MI and AF were older than those without AF (mean age 75.2 ± 10.1 versus 64.6 ± 12.8, p <0.0001), among them there were more women (52.4% versus 35.5% in patients without AF, p <0.0001). Type 2 MI occurred 5 times more often among patients with MI and AF (p <0.0001). Further, 2 study groups were formed - the main (100 patients with type 1 MI and preexisting AF) and control (type 1 MI 200 patients without AF), adjusted for sex (58% of women in both groups), age (mean age 75.5 ± 8, 7 in the main group versus 75.2 ± 8.5 in the control group, p = 0.775). DM (45% versus 31.5%, p = 0.030), previous MI (40% versus 25.5%, p = 0.012) and stroke (21% vs. 11.5%, p = 0.037) were more common in the main group than in the control. Patients with MI and AF had lower GFR (56.8 ± 19.4 versus 61.7 ± 17.9 ml / min / 1.73 m2, p = 0.031), LDL (2.8 ± 0.9 versus 3.3 ± 1.0 mmol/L, p = 0.0002). Patients with AF had a lower left ventricular ejection fraction (55.2 ± 10.5 versus 59.8 ± 10.0 %, p = 0.0005). Significant mitral regurgitation was more common in the 1-st group (53.9% versus 30.3% in the control group, p = 0.0002). There were no significant differences in the incidence of acute heart failure (HF) (Killip 3-4) (20% versus 13%, p = 0.127). Patients in the 1-st and 2-nd groups did not differ in the number of affected coronary artery (p = 0.7327), the level of their damage (p = 0.1956), in the frequency of revascularization (p = 0.0686). Patients with MI and AF had worse in-hospital prognosis. Pulmonary embolism (PE) (9% in patients with AF versus 1% in patients without AF, p = 0.0011), minor bleeding (21% versus 9.5%, p = 0.0057), combined endpoint (stroke + PE + mortality) (19% versus 10.5%, p = 0.0415) were more common in the main group. At discharge, patients with AF had chronic HF III NYHA in 21.8% cases versus 5.5% in patients without AF, p = 0.0001. There were no significant differences in other endpoints (recurrent MI, stroke, major bleeding, and total mortality) between the groups during hospitalization. In-hospital mortality was 13% in the main versus 9.5% in the control group (p = 0.4276). Conclusion  AF occurs in 18.6% of patients with MI. Patients with AF and MI are older with the prevalence of females. Patients with type 1 MI and pre-existing AF is a group of high risk. PE, severe chronic HF, minor bleeding, and combined endpoint (stroke + PE + mortality) were significantly common among them.

scholarly journals In-hospital prognosis in patients with myocardial infarction and atrial fibrillation

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
I Leonova ◽  
M Solovyeva ◽  
S Boldueva ◽  
E Bykova
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Left Ventricular ◽  
Main Group ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Minor Bleeding ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The number of patients with myocardial infarction (MI) and atrial fibrillation (AF) is increasing every year. Purpose to assess the incidence of AF among the patients with MI, the features of the in-hospital prognosis among the patients with MI and AF compared with MI without AF. Methods The patients with type 1 MI and preexisting AF have been selected from all MI patients MI admitted in 2013-18. They have formed the main group (100 patients). The control group (200 patients with type 1 MI without AF), has been created by "pair selection" method. Patients in the groups did not differ in gender, age, MI date and had not severe comorbidities. Results 1660 patients with MI were analyzed. AF occurred in 309 patients (18.6% of patients with MI). Preexisting AF was in 59.2%. Patients with MI and AF were older than MI without AF (mean age 75.2 ± 10.1 versus 64.6 ± 12.8, p <0.0001) with women’s prevalence (52.4% versus 35.5%, p <0.0001). Type 1 MI predominates among all patients. Type 2 MI occurred 5 times more often among main group (p <0.0001). 2 groups were adjusted for sex (58% of women in both groups), age (mean age 75.5 ± 8, 7 in the main versus 75.2 ± 8.5 in the control group, p = 0.775). Diabetes (45% versus 31.5%, p = 0.030), previous MI (40% versus 25.5%, p = 0.012) and stroke (21% versus 11.5%, p = 0.037) were more common in the main than in the control. Patients with MI and AF had lower GFR (56.8 ± 19.4 versus 61.7 ± 17.9 ml/min/1.73 m2, p = 0.031), LDL (2.8 ± 0.9 versus 3.3 ± 1.0 mmol/L, p = 0.0002). Patients with AF had a lower left ventricular ejection fraction (55.2 ± 10.5 versus 59.8 ± 10.0 %, p = 0.0005). Significant mitral regurgitation was more common in the main group (53.9% versus 30.3% in the control group, p = 0.0002). There were no differences in the incidence of acute heart failure (HF) Killip’s 3-4 (20% versus 13%, p = 0.127). Patients did not differ in the number of affected coronary artery (p = 0.7327), the level of stenosis (p = 0.1956), in the frequency of revascularization (p = 0.0686). Patients with MI and AF had worse in-hospital prognosis. Pulmonary embolism (PE) (9% in main versus 1% in control group, p = 0.0011), minor bleeding (21% versus 9.5%, p = 0.0057), combined endpoint (stroke + PE + mortality) (19% versus 10.5%, p = 0.0415) were more common in the main group. At discharge, patients with AF had HF III NYHA in 21.8% cases versus 5.5% in patients without AF, p = 0.0001. There were no significant differences in other in-hospital endpoints (recurrent myocardial infarction, stroke, major bleeding, and mortality) between the groups. In-hospital mortality was 13% in the main versus 9.5% in the control group (p = 0.4276). Conclusion AF occurs in 18.6% of patients with MI. Patients with AF and MI are older with female prevalence. Type 1 MI predominates. Patients with type 1 MI and pre-existing AF is a group of high risk because of more severe HF, PE, minor bleeding and combined endpoint (stroke + PE + mortality)

Сlinical and epidemiological profiles and tactics of patient’s management with myocardial infarction with non-obstructive coronary arteries

2020 ◽  
Vol 22 (4) ◽  
pp. 12-16
Author(s):  
D. V. Trishkin ◽  
K. S. Shulenin ◽  
D. V. Cherkashin ◽  
G. G. Kutelev ◽  
S. V. Efimov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Main Group ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Artery Disease

A comparative analysis of clinical and epidemiological data and results of treatment of 7 patients suffering from myocardial infarction without obstructive coronary artery disease (main group) and 54 patients with their lesions (control group) aged 45,69,3 and 62,714,2 years, respectively. Both groups were dominated by men (85,7% and 72,2%, respectively). In the main group, dyslipidemia and hypertension were less common (14,3 and 28,6%, respectively) than in the control group (61,1 and 72,2%, respectively). At the same time, the former had a more burdened history of early cardiovascular events in close relatives in 28,6% of cases, and the latter-only in 5,6% of cases. Surgical tactics and features of double antiplatelet therapy in myocardial infarction without obstructive coronary artery disease did not differ from the standard approach. In both groups, active surgical tactics prevailed, consisting in performing percutaneous coronary intervention and installing a coronary stent in the infarct-related artery (85,7 and 83,3%, respectively). The choice of dual antiplatelet therapy in the main group did not differ from the control group and was characterized by a significantly higher frequency of clopidogrel administration (71,4 and 72,2%, respectively). When comparing the left ventricular ejection fraction before and after percutaneous coronary intervention, it turned out that in patients of the main group, in contrast to the control group, the value of the left ventricular ejection fraction did not change significantly (52,56,4 and 51,39,5, respectively). The etiology and pathogenesis of myocardial damage in patients suffering from myocardial infarction without obstructive coronary artery disease is characterized by significant heterogeneity, which requires additional examinations and differential diagnostics to identify the underlying causes of this condition.

STUDY THE CHANGES IN MORPHOLOGY AND LEFT VENTRICULAR FUNCTION IN OVERWEIGHT-OBESE CHILDREN 5-15 YEARS OLD WHO VISITED CHILDREN'S HOSPITAL IN CAN THO

2011 ◽  
pp. 36-42
Author(s):  
Hung Viet Bui ◽  
Thi Cu Nguyen
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Obese Children ◽  
Ventricular Ejection Fraction ◽  
Children's Hospital ◽  
Number Of Patients ◽  
Children’S Hospital

Objective: In Vietnam, obesity is increasing particularly in many large cities. Adult cardiovascular diseases are often derived from cardiovascular disorders during the children period. The implementation of early measures to prevent atherosclerosis, such as weight control, better lipid control will reduce the cardiovascular complications, such as hypertension (HTA), coronary heart diseases and some other diseases. Materials and Methods: Overweight - obese children from 5 to 15 years old who visited the Children's Hospital in Can Tho from May 2009 to May 2010. Total number of patients were chosen as 50 children. Method: Descriptive cross-sectional. Children in the study underwent Doppler ultrasound exam to evaluate cardiac morphology and cardiac function. Results: There were increases in left ventricular systolic diameter, left ventricular diastolic diameter, LV mass in overweight-obese children in the study compared with controls at all ages (p <0.05 ). Left ventricular ejection fraction in overweight-obese children in the study was lower than the control group at all ages (p> 0.05). The average rate of left ventricular shortening of overweight-obese children in the study was 34.8 ± 4.5(%). There was no difference in the rate of shortening of the left ventricle in overweight-obese children in the study compared with controls (p>0.05). There was no relationship between variation in morphology and left ventricular function with the degree of overweight-obesity in this study. Conclusion: The study showed that disturbances in morphology and left ventricular function in overweight-obese children but did not find a strong association with the disorder degree of overweight-obesity.

Delivery of CD151 by Ultrasound Microbubbles in Rabbit Myocardial Infarction

Cardiology ◽  
2016 ◽  
Vol 135 (4) ◽  
pp. 221-227 ◽  
Author(s):  
Shao-Ling Yang ◽  
Ke-Qiang Tang ◽  
Jun-Jia Tao ◽  
Ai-Hong Wan ◽  
Yan-Duan Lin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Function ◽  
Rabbit Model ◽  
Physiological Saline ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Therapeutic Effects ◽  
Ventricular Ejection Fraction ◽  
Cluster Of Differentiation

Objectives: We aimed to evaluate whether ultrasound (US) and microbubble-mediated delivery of Cluster of Differentiation 151 (CD151) could enhance the therapeutic effects of CD151 on myocardial infarction (MI). Methods: A rabbit model of MI was established by a modified Fujita method. Then, 50 MI rabbits were randomly divided into 5 groups, including G1 (CD151 plasmid and physiological saline in the presence of US); G2 (CD151 and Sonovue in the presence of US); G3 (CD151 and Sonovue in the absence of US); G4 (Sonovue in the absence of US), and a control group (physiological saline in the absence of US). After 14 days of treatment, the expression of CD151 was detected by Western blot. Besides, vessel density of peri-infarcted myocardium was measured by immunohistochemistry, and cardiac function was analyzed by echocardiography. Results: The rabbit model of MI was established successfully. CD151 injection increased the expression of CD151 and microvessel density in the myocardium of MI rabbits. Heart function was significantly improved by CD151, which exhibited increased left ventricular ejection fraction, left ventricular fractional shortening and a reduced Tei index. Besides, US Sonovue significantly increased the expression efficiency of CD151. Conclusion: US microbubble was an effective vector for CD151 delivery. CD151 might be an effective therapeutic target for MI.

Abstract 177: Ticagrelor, but not Clopidogrel, Protects the Heart Against Reperfusion Injury and Improves Remodeling After Myocardial Infarction

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Yumei Ye ◽  
Jose R Perez-Polo ◽  
Manjyot K Nanhwan ◽  
Sven Nylander ◽  
Yochai Birnbaum
Keyword(s):  
Myocardial Infarction ◽  
Platelet Aggregation ◽  
Reperfusion Injury ◽  
Heart Function ◽  
Oral Treatment ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Coronary Artery Ligation ◽  
Ventricular Ejection Fraction

Background: Clopidogrel (C) and Ticagrelor (T) are P2Y12 ADP receptor antagonists. In addition, ticagrelor inhibits adenosine cell uptake. In PLATO trial T reduced the incidence of the primary composite endpoint myocardial infarction, stroke or cardiovascular death over C in patients with acute coronary syndromes. Previous data show that 7d pretreatment with T limits infarct size (IS) in rats. We compared the effects of C and T, administered just before reperfusion on IS. We also assessed the effect of T and C, administered just before reperfusion and/or 6w oral treatment on cardiac remodeling. Methods: Rats underwent 30min coronary artery ligation. 1) At 25min of ischemia rats received intraperitoneal (IP) vehicle, T (10 or 30mg/kg), or C (12.5mg/kg). Area at risk (AR) was assessed by blue dye and IS by TTC staining 24h after reperfusion. 2) Rats received vehicle without (sham) or with (control) coronary ischemia, T (30mg/kg) IP (TIP), T (300mg/kg/d) oral for 6w, started a day after reperfusion (TPO), TIP+PO (TIPPO), or C (12.5mg/kg IP +62.5mg/kg/d PO for 6w). LV dimensions and function was assessed by echo at 6w. Results: 1) AR was comparable among groups. IS was 45.3±1.7% of the AR in the control group. T10 (31.5±1.8%; p=0.001) and T30 (21.4±2.6% p<0.001) significantly reduced IS, whereas C (42.4±2.6%) had no effect. Platelet aggregation in the controls was 64.7±1.3% and was comparable in T30 (24.9±1.8%) and C (23.2±1.8%) at 2h post reperfusion. T30 increased Akt, eNOS and ER1/2 phosphorylation 4h after reperfusion, whereas C had no effect. 2) Platelet aggregation at 1w oral treatment was 59.7±3.2% in the control group and was comparable in TIPPO (18.1±1.3%) and C (17.4±0.7%). Left ventricular ejection fraction was 77.6±0.9%*, 44.8±3.5%, 69.5±1.6%*, 69.2±1.0%*, 76.3±1.2%*, and 37.4±3.7% in the sham, vehicle, TIP, TPO, TIPPO and C treated group, respectively (*p<0.001 vs. vehicle). Left ventricular diameters at diastole and systole showed the same pattern. Conclusions: T, but not C, administered just before reperfusion protects against reperfusion injury. Oral T (in combination or not with acute treatment just before reperfusion) treatment for 6w improves heart function. C, despite achieving similar degree of platelet inhibition had no effect on remodeling.

scholarly journals Prognostic value of atrial fibrillation in patients with heart failure and different left ventricular ejection fraction: results of the multicenter RIF-CHF register

2021 ◽  
Vol 26 (1) ◽  
pp. 4200
Author(s):  
I. V. Zhirov ◽  
N. V. Safronova ◽  
Yu. F. Osmolovskaya ◽  
S. N. Тereschenko
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Cardiovascular Mortality ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Number Of Patients ◽  
Increased Risk

Heart failure (HF) and atrial fibrillation (AF) are the most common cardiovascular conditions in clinical practice and frequently coexist. The number of patients with HF and AF is increasing every year.Aim. To analyze the effect of clinical course and management of HF and AF on the outcomes.Material and methods. The data of 1,003 patients from the first Russian register of patients with HF and AF (RIF-CHF) were analyzed. The endpoints included hospitalization due to decompensated HF, cardiovascular mortality, thromboembolic events, and major bleeding. Predictors of unfavorable outcomes were analyzed separately for patients with HF with preserved ejection fraction (AF+HFpEF), mid-range ejection fraction (AF+HFmrEF), and reduced ejection fraction (AF+HFrEF).Results. Among all patients with HF, 39% had HFpEF, 15% — HFmrEF, and 46% — HFrEF. A total of 57,2% of patients were rehospitalized due to decompensated HF within one year. Hospitalization risk was the highest for HFmrEF patients (66%, p=0,017). Reduced ejection fraction was associated with the increased risk of cardiovascular mortality (15,5% vs 5,4% in other groups, p<0,001) but not ischemic stroke (2,4% vs 3%, p=0,776). Patients with HFpEF had lower risk to achieve the composite endpoint (stroke+MI+cardiovascular death) as compared to patients with HFmrEF and HFrEF (12,7% vs 22% and 25,5%, p<0,001). Regression logistic analysis revealed that factors such as demographic characteristics, disease severity, and selected therapy had different effects on the risk of unfavorable outcomes depending on ejection fraction group.Conclusion. Each group of patients with different ejection fractions is characterized by its own pattern of factors associated with unfavorable outcomes. The demographic and clinical characteristics of patients with mid-range ejection fraction demonstrate that these patients need to be studied as a separate cohort.

scholarly journals Role of atrial arrhythmia and ventricular response in atrial fibrillation induced atrial remodelling

2020 ◽  
Author(s):  
Jean-Baptiste Guichard ◽  
Feng Xiong ◽  
Xiao-Yan Qi ◽  
Nathalie L’Heureux ◽  
Roddy Hiram ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Ventricular ◽  
Atrial Arrhythmia ◽  
Ventricular Rate ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Arrhythmogenic Substrate ◽  
Atrial Remodelling ◽  
Ventricular Response

Abstract Aims No studies have assessed the specific contributions of atrial fibrillation (AF)-related atrial vs. associated ventricular arrhythmia to remodelling. This study assessed the roles of atrial arrhythmia vs. high ventricular rate in AF-associated remodelling. Methods and results Four primary dog-groups (12/group) were subjected to 3-week pacing: 600-b.p.m. atrial tachypacing maintaining AF [AF w/o- atrioventricular block (AVB)]; atrial tachypacing with atrioventricular-node ablation (AF+AVB) and ventricular-demand pacing (80 b.p.m.); 160-b.p.m. ventricular-tachypacing (V160) reproducing the response rate during AF; and sinus rhythm with AVB/ventricular-pacing at 80-b.p.m. (control group). At terminal study, left-atrial (LA) effective refractory period (ERP) was reduced equally in both AF groups (w/o-AVB and AF+AVB). AF-inducibility was increased strongly in AF groups (w/o-AVB and AF+AVB) and modestly in V160. AF duration was significantly increased in AF w/o-AVB but not in AF+AVB or V160. Conduction velocity was decreased in AF w/o-AVB, to a greater extent than in AF+AVB and V160. Atrial fibrous-tissue content was increased in AF w/o-AVB, AF+AVB and V160, with collagen-gene up-regulation only in AF w/o-AVB. Connexin43 gene expression was reduced only in AF w/o-AVB. An additional group of 240-b.p.m. ventricular tachypacing dogs (VTP240; to induce heart failure) was studied: vs. other tachypaced groups, VTP240 caused greater fibrosis, but no change in LA-ERP or AF-inducibility. VTP240 also increased AF duration, strongly decreased left ventricular ejection fraction, and was the only group with LA natriuretic-peptide activation. Conclusion The atrial tachyarrhythmia and rapid ventricular response during AF produce distinct atrial remodelling; both contribute to the arrhythmogenic substrate, providing new insights into AF-related remodelling and novel considerations for ventricular rate-control.

Improved quality of life with cardiac rehabilitation for post-myocardial infarction patients in Korea

2007 ◽  
Vol 6 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Jina Choo ◽  
Lora E. Burke ◽  
Kyung Pyo Hong
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Supervised Exercise

Background Health-related quality of life (HRQOL) has been used as a primary health outcome in cardiac rehabilitation programs (CRP). Aims This study aimed to evaluate the effects of an 8-week CRP on HRQOL and exercise capacity in myocardial infarction (MI) patients in Korea. Methods After matching on gender, age, and left ventricular ejection fraction, 60 subjects with a first acute MI were allocated to either a CRP group ( n =31) or a Control group ( n =29). The 8-week CRP included hospital-based, supervised exercise training (three times per week, average intensity of 65% VO2peak) and individual education sessions. The Control group was instructed on a home-based exercise regimen without contact during the 8 weeks. At baseline and 8 weeks, HRQOL was assessed by the Quality of Life Index (QLI)–cardiac version III; exercise capacity by a treadmill test. Results After adjusting for education level, the overall QLI, health/functioning and psycho/spiritual scores showed greater increases in the CRP group than the Control group ( p=.014, p=.016, and p=.036, respectively). We observed significant improvements in VO2peak ( p<.0001), anaerobic threshold ( p<.0001), and maximal exercise duration ( p<.0001) in the CRP group, compared to the Control group. Conclusions These findings suggest that the Korean CRP can lead to significant improvements in HRQOL outcomes and exercise capacity.

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