scholarly journals Circulating Galectin-3 Levels Are Increased in Patients with Ischemic Heart Disease, but Are Not Influenced by Acute Myocardial Infarction

Cardiology ◽  
2016 ◽  
Vol 134 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Erlend G. Singsaas ◽  
Cord A. Manhenke ◽  
Kenneth Dickstein ◽  
Stein Orn
Keyword(s):  
Myocardial Infarction ◽  
Troponin T ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Volume Index ◽  
Systolic Volume ◽  
Increased Risk ◽  
Galectin 3 ◽  
Group 2 ◽  
Group 1

Objectives: Galectin-3 (Gal-3) is involved in cardiac inflammation and fibrosis, and is in use as a biomarker that indicates increased risk in heart failure. This study examined the relationship between Gal-3 levels and acute and old myocardial infarction (MI) in patients assessed by cardiac magnetic resonance (CMR) imaging. Methods: Group 1 consisted of 38 patients with ST-elevation MI and single-vessel disease treated with primary percutaneous coronary intervention (PCI). Group 2 consisted of 52 patients with prior complicated MI. Twenty-two controls were included. CMR was performed in group 1 at 2 days, 1 week, 2 months and 1 year following PCI and in group 2 at >4 years after MI. Results: Median Gal-3 was elevated in patients compared with controls, group 1: 11.93 ng/ml (IQR 6.34-17.52, p = 0.03), group 2: 12.96 (IQR 6.33-19.29, p = 0.03) and controls: 10.16 (IQR 5.59-14.73). Gal-3 levels did not change during acute MI, and there was no relationship between Gal-3 and infarct size, troponin-T, high-sensitivity C-reactive protein, left-ventricular (LV) volumes or LV ejection fraction (LVEF) in group 1. In group 2, Gal-3 correlated modestly with MI size (r = 0.28, p < 0.05), LV end-diastolic volume index (r = 0.40, p < 0.01), LV end-systolic volume index (r = 0.43, p < 0.01) and LVEF (r = -0.39, p < 0.01). Conclusion: There was no relationship between Gal-3 levels and acute ischemic myocardial injury. A significant, modest relationship between Gal-3 levels, MI size and LV remodeling was only found in patients with old MI.

P3095Left ventricular thrombus formation after ST-elevation myocardial infarction: a prospective observational CMR study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Holzknecht ◽  
S J Reinstadler ◽  
M Reindl ◽  
C Tiller ◽  
A Mayr ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin T ◽  
Thrombus Formation ◽  
Multivariable Analysis ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Lv Function ◽  
Culprit Lesion ◽  
St Segment Elevation ◽  
Systolic Volume

Abstract Background Left ventricular (LV) thrombus formation is a severe complication after acute ST-segment elevation myocardial infarction (STEMI). The incidence and determinants of LV thrombus formation are still a matter of controversy. Purpose We aimed to assess the incidence as detected by cardiac magnetic resonance (CMR) imaging as well as the determinants of LV thrombus formation in contemporary reperfused STEMI patients. Methods This prospective observational study included 530 consecutive STEMI patients treated with primary percutaneous coronary intervention (PCI). Comprehensive CMR was performed at a median of 3 days (interquartile range 2–4 days) after symptom onset for the evaluation of LV thrombus formation as well as LV function and infarct severity. Results LV thrombi were detected in 17 patients (3.2% of the overall cohort). The incidence of LV thrombi in anterior STEMI patients (n=247) was 6.9%. In all patients presenting with LV thrombus left anterior descending artery (LAD) was identified as culprit lesion. The occurrence of thrombi was significantly associated with reduced LV ejection fraction (LVEF) (p<0.001), larger LV end-diastolic volume (p<0.001) and LV end-systolic volume (p<0.001), larger areas of microvascular obstruction (MVO) (p=0.003) and larger infarct size (IS) (p<0.001). Furthermore, increased levels of peak high sensitivity cardiac Troponin T (p<0.001) and hyperlipidaemia (p=0.038) were significantly related to LV thrombi. In multivariable analysis including IS, LVEF and MVO, only LVEF (odds ratio: 0.91 (95% confidence interval: 0.87–0.96); p=0.001) emerged as independent predictor of LV thrombus formation. Conclusion The risk of LV thrombus formation remains considerable in contemporary treated STEMI patients, especially in those with LAD as culprit lesion. Among CMR parameters of LV dysfunction and infarct severity, only baseline LVEF, but not IS or MVO, independently predicted LV thrombus formation after STEMI.

scholarly journals The outcome of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) and impaired kidney function: a 3-year observational study

2021 ◽  
Author(s):  
Malgorzata Zalewska-Adamiec ◽  
Jolanta Malyszko ◽  
Ewelina Grodzka ◽  
Lukasz Kuzma ◽  
Slawomir Dobrzycki ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Incidence Rate ◽  
Kidney Function ◽  
Coronary Arteries ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Risk Of Death ◽  
Group 2 ◽  
Group 1

Abstract Background Myocardial infarction with nonobstructive coronary arteries (MINOCA) constitutes about 10% of the cases of acute coronary syndromes (ACS). It is a working diagnosis and requires further diagnostics to determine the cause of ACS. Methods In this study, 178 patients were initially diagnosed with MINOCA over a period of 3 years at the Department of Invasive Cardiology of the University Clinical Hospital in Białystok. The value of estimated glomerular filtration rate (eGFR) was calculated for all patients. The patients were divided into 2 groups depending on the value of eGFR: group 1—53 patients with impaired kidney function (eGFR < 60 mL/min/1.73 m2; 29.8%) and group 2—125 patients with normal kidney function (eGFR ≥ 60 mL/min/1.73 m2; 70.2%). Results In group 1, the mean age of patients was significantly higher than that of group 2 patients (77.40 vs 59.27; p < 0.0001). Group had more women than group 2 (73.58% vs 49.60%; p = 0.003). Group 1 patients had higher incidence rate of arterial hypertension (92.45% vs 60.80%; p < 0.0001) and diabetes (32.08% vs 9.60%; p = 0.0002) and smoked cigarettes (22.64% vs 40.80%; p = 0.020). Group 1 patients had higher incidence rate of pulmonary edema, cardiogenic shock, sudden cardiac arrest (13.21% vs 4.00%; p = 0.025), and pneumonia (22.64% vs 6.40%; p = 0.001). After the 37-month observation, the mortality rate of the patients with MINOCA was 16.85%. Among group two patients, more of them became deceased during hospitalization (7.55% vs 0.80%; p = 0.012), followed by after 1 year (26.42% vs 7.20%; p = 0.0004) and after 3 years (33.96% vs 9.6%; p < 0.0001). Multivariate analysis revealed that the factors increasing the risk of death in MINOCA are as follows: older age, low eGFR, higher creatinine concentration, low left ventricular ejection fraction, and ST elevation in ECG. Conclusion Impaired kidney function is diagnosed in every third patient with MINOCA. Early and late prognosis of patents with MINOCA and renal dysfunction is poor, and their 3-year mortality is comparable to patients with myocardial infarction with significant stenosis of the coronary arteries and impaired kidney function.

scholarly journals Intracoronary Injection of CD133-Positive Enriched Bone Marrow Progenitor Cells Promotes Cardiac Recovery After Recent Myocardial Infarction

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Jozef Bartunek ◽  
Marc Vanderheyden ◽  
Bart Vandekerckhove ◽  
Samer Mansour ◽  
Bernard De Bruyne ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bone Marrow ◽  
Progenitor Cells ◽  
Left Ventricular ◽  
Recent Myocardial Infarction ◽  
Stent Restenosis ◽  
Intracoronary Administration ◽  
Group 2 ◽  
In Stent Restenosis ◽  
Group 1

Background— Bone marrow CD133-postive (CD133 + ) cells possess high hematopoietic and angiogenic capacity. We tested the feasibility, safety, and functional effects of the use of enriched CD133 + progenitor cells after intracoronary administration in patients with recent myocardial infarction. Methods and Results— Among 35 patients with acute myocardial infarction treated with stenting, 19 underwent intracoronary administration of CD133 + progenitor cells (12.6±2.2×10 6 cells) 11.6±1.4 days later (group 1) and 16 did not (group 2). At 4 months, left ventricular ejection fraction increased significantly in group 1 (from 45.0±2.6% to 52.1±3.5%, P <0.05), but only tended to increase in case-matched group 2 patients (from 44.3±3.1% to 48.6±3.6%, P =NS). Likewise, left ventricular regional chordae shortening increased in group 1 (from 11.5±1.0% to 16.1±1.3%, P <0.05) but remained unchanged in group 2 patients (from 11.1±1.1% to 12.7±1.3%, P =NS). This was paralleled by reduction in the perfusion defect in group 1 (from 28.0±4.1% to 22.5±4.1%, P <0.05) and no change in group 2 (from 25.0±3.0% to 22.6±4.1%, P =NS). In group 1, two patients developed in-stent reocclusion, 7 developed in-stent restenosis, and 2 developed significant de novo lesion of the infarct-related artery. In group 2, four patients showed in-stent restenosis. In group 1 patients without reocclusion, glucose uptake shown by positron emission tomography with 18 fluorodeoxyglucose in the infarct-related territory increased from 51.2±2.6% to 57.5±3.5% ( P <0.05). No stem cell-related arrhythmias were noted, either clinically or during programmed stimulation studies at 4 months. Conclusion— In patients with recent myocardial infarction, intracoronary administration of enriched CD133 + cells is feasible but was associated with increased incidence of coronary events. Nevertheless, it seems to be associated with improved left ventricular performance paralleled with increased myocardial perfusion and viability.

scholarly journals Predictors of Left Ventricular Remodeling after Revascularized Acute Myocardial Infarction

2016 ◽  
Vol 1 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Sorin Pop ◽  
Roxana Hodaş ◽  
Edvin Benedek ◽  
Diana Opincariu ◽  
Nora Rat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Group 2 ◽  
Group 1

AbstractBackground:The acute loss of myocardium, following an acute myocardial infarction (AMI) leads to an abrupt increase in the loading conditions that induces a pattern of left ventricular remodeling (LVR). It has been shown that remodeling occurs rapidly and progressively within weeks after the AMI.Study aim:The aim of our study was to identify predictors for LVR, and find correlations between them and the cardiovascular (CV) risk factors that lead to remodeling.Material and methods:One hundred and five AMI patients who underwent primary PCI were included in the study. A 2-D echocardiography was performed at baseline (day 1 ± 3 post-MI) and at 6 months follow-up. The LV remodeling index (RI), was defined as the difference between the Left Ventricular End-Diastolic diameter (LVEDD) at 6 months and at baseline. The patients were divided into 2 groups, according to the RI: Group 1 – RI >15% with positive remodeling (n = 23); Group 2 – RI ≤15% with no remodeling (n = 82).Results:The mean age was 63.26 ± 2.084 years for Group 1 and 59.72 ± 1.267 years for Group 2. The most significant predictor of LVR was the female gender (Group 1 – 52% vs. Group 2 – 18%, p <0.0001). Men younger than 50 years showed a lower rate of LVR (Group1 – 9% vs. Group 2 – 20%, p = 0.0432). In women, age over 65 years was a significant predictor for LVR (Group 1 – 26% vs. Group 2 – 9%, p = 0.0025). The CV risk factors associated with LVR were: smoking (p = 0.0008); obesity (p = 0.013); dyslipidemia (p = 0.1184). The positive remodeling group had a higher rate of LAD stenosis compared to the no-remodeling group (48% vs. 26%, p = 0.002). The presence of multi-vessel disease was shown to be higher in Group 1 (26% vs. 9%, p = 0.0025). The echocardiographic parameters that predicted LVR were: LVEF <45% (p = 0.048), mitral regurgitation (p = 0.022), and interventricular septum hypertrophy (p <0.0001).Conclusions:The CV risk factors correlated with LVR were smoking, obesity and dyslipidemia. A >50% stenosis in the LAD and the presence of multi-vessel CAD were found to be significant predictors for LVR. The most powerful predictors of LVR following AMI were: LVEF <45%, mitral regurgitation, and interventricular septum hypertrophy.

scholarly journals Effects of High Loading Dose of Clopidogrel in ST Elevated Myocardial Infarction Treated with Fibrinolytic Agent

2013 ◽  
Vol 36 (1) ◽  
pp. 18 ◽  
Author(s):  
Hatice Solmaz ◽  
Mehmet Akbulut ◽  
Hasan Korkmaz ◽  
Mustafa F Yavuzkir ◽  
Oğuz K Kaya ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Sensitivity ◽  
Serum Levels ◽  
Fibrinolytic Therapy ◽  
Loading Dose ◽  
Cardiology Clinic ◽  
Group 3 ◽  
Group 2 ◽  
Hs Crp ◽  
Group 1

Purpose: The purpose of the present study was to evaluate the effects of different loading doses of clopidogrel on ST segment resolution on ECG, changes in cardiac enzyme levels and serum levels of high-sensitivity C-reactive protein (Hs-CRP) in patients with ST elevated myocardial infarction (STEMI) treated with fibrinolytic therapy. Methods: Patients admitted to our cardiology clinic with a diagnosis of STEMI and treated with fibrinolytic therapy were included: Group 1 (n=58) received a 300 mg loading dose of clopidogrel, Group 2 (n=55) a 450 mg loading dose and Group 3 (n=59) a 600 mg loading dose. A 75 mg/d maintanence dose of clopidogrel was given in all groups. Results: All demographic characteristics and baseline laboratory parameters were statistically similar among three groups (p > 0.05). When ST resolution periods were compared, most patients in Group 3 had ST resolution at 30 minutes; Group 2 at 60 minutes and Group 1 at 90 minutes (p < 0.05). Peak levels of creatine kinase (CK) and CK-MB were as follows: Group 3, 8th hour, Group 1 and 2, 12th hour. Peak levels of those enzymes were significantly lower in Group 3 than in Group 1 and 2 ( < 0.05). Although basal hs-CRP levels of all groups were similar, the increase in hs-CRP levels at 48 hours was lower with higher clopidogrel loading doses (p < 0.05). Conclusion: In this study comparing three different clopidogrel loading doses, the higher doses provided earlier ECG resolution, earlier and lower peak CK and CK-MB levels and lower levels of hs-CRP.

Comparison of Rosuvastatin versus Atorvastatin for Preventing Postoperative Atrial Fibrillation

2013 ◽  
Vol 16 (3) ◽  
pp. 158 ◽  
Author(s):  
Okay Abaci ◽  
Cuneyt Kocas ◽  
Veysel Oktay ◽  
Cenk Eray Yildiz ◽  
Kadriye Orta Kilickesmez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Left Ventricular ◽  
Postoperative Atrial Fibrillation ◽  
Atorvastatin Treatment ◽  
Elective Cardiac Surgery ◽  
Increased Risk ◽  
History Of ◽  
Group 2 ◽  
Group 1

<p><b>Background:</b> Postoperative atrial fibrillation (AF) following cardiac surgery is associated with an increased risk of stroke, prolonged hospitalization, and increased costs. Statin therapy is associated with a lower incidence of postoperative AF. We aimed to compare the preventive effects of rosuvastatin and atorvastatin on postoperative AF.</p><p><b>Methods:</b> This study included 168 patients undergoing elective cardiac surgery with cardiopulmonary bypass. Patients were divided into 2 groups according to treatment of statin. Group 1 (n = 96) was patients receiving atorvastatin, and group 2 (n = 72) was patients receiving rosuvastatin. Postoperative electrocardiographs (ECGs) and telemetry strips were examined for AF within postoperative period during hospitalization.</p><p><b>Results:</b> The incidences of postoperative AF were 17.9% (n = 17) in group 1 and 22.2% (n = 16) in group 2 (<i>P</i> = .48). Left ventricular end-diastolic diameter (LVEDD) and ejection fraction (EF) were not different between groups. Incidence of diabetes, hypertension, hyperlipidemia, smoking, myocardial infarction in past medical history, family history of atherosclerosis, male sex, drug use, and perioperative features were similar between groups.</p><p><b>Conclusions:</b> The present study revealed that preoperative rosuvastatin or atorvastatin treatment did not have a different effect in preventing postoperative AF.</p>

Functional Significance of Collateral Circulation in Patients with Total Coronary Occlusion

1993 ◽  
Vol 1 (4) ◽  
pp. 156-162
Author(s):  
Ha Jong Won ◽  
Cho Seung Yun ◽  
Jang Yang Soo ◽  
Chung Nam Sik ◽  
Shim Won Hewn ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Collateral Circulation ◽  
Coronary Occlusion ◽  
Artery Occlusion ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Segmental Wall Motion ◽  
Group 2 ◽  
Group 1

Functional significance of collateral circulation was evaluated in 125 patients with total coronary occlusion. Patients were classified into 2 groups: group 1, patients without myocardial infarction; and group 2, patients with a first transmural myocardial infarction occurring within 3 months of symptom onset. There was a higher prevalence of well-developed collaterals and multivessel disease in patients without myocardial infarction than in those with myocardial infarction. The left ventricular ejection fraction, left ventricular enddiastolic pressure, and segmental wall motion scores were significantly better in group 1 than group 2. Despite total coronary occlusion, 61% of group 1 had a normal resting electrocardiogram; however, 96% of patients who underwent treadmill tests proved positive. The proportions of well-developed collaterals in 3 groups, divided according to the internal between onset of myocardial infarction and angiography (within 1 day of operation, 2 to 14 days, or 15 days to 3 months), were 13%, 54%, and 60%. There were no significant differences in left ventricular ejection fraction, segmental wall motion score, and left ventricular enddiastolic pressure in myocardial infarction patients with poorly developed collaterals and well-developed collaterals. The degree of collateral development is higher in myocardial infarction with right coronary artery occlusion compared with that of left anterior descending artery occlusion, without regarding the dominancy or length. Collateral circulation can prevent myocardial ischemia and present myocardial function in a significant number of patients without infarction; however, it does not provide protection against exercise-induced myocardial ischemia in the majority of patients from group 1. Although well-developed collaterals are not usually present within 1 day after myocardial infarction, they are generally present after 2 weeks. Collateral vessels in patients with myocardial infarction have no beneficial effects on preserving myocardial function.

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