scholarly journals Bone marrow mesenchymal stem cells transfer in patients with ST-segment elevation myocardial infarction: single-blind, randomized controlled muticentre trial

2020 ◽  
Author(s):  
Runfeng Zhang ◽  
Jiang Yu ◽  
Ningkun Zhang ◽  
Wensong Li ◽  
Jisheng Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
General Hospital ◽  
Myocardial Viability ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
St Segment Elevation ◽  
Lv Ejection Fraction

Abstract Objective: Our aimed to evaluate efficacy and safety of intracoronary autologous bone morrow mesenchymal stem cells (BM-MSCs) transplantation in patients with ST-segment elevation myocardial infarction（STEMI）. Methods: In this randomised, single-blind, controlled trial, patients with STEMI (aged 39-76 years) were enrolled at 6 centers in Beijing (the People's Liberation Army Navy General Hospital, Beijing Armed Police General Hospital, Chinese People's Liberation Army General Hospital, Beijing Huaxin Hospital, Beijing Tongren Hospital, Beijing Chaoyang Hospital West Hospital). Patients underwent optimum medical treatment and percutaneous coronary intervention,and were randomly assigned in a 1:1 ratio to BM-MSCs group or control group. The primary endpoint was change of myocardial viability at 6 months' follow-up and left-ventricular (LV) function at 12 months' follow-up.The secondary endpoints were incidence of cardiovascular event, total mortality and adverse event at 12 months' follow-up. The myocardial viability assessed by single- photon emission tomography (SPECT). The left ventricular ejection fraction was used to assess LV function. All patients underwent dynamic ECG and laboratory evaluations. This trial is registered with ClinicalTrails.gov, number NCT04421274. Results: Between March , 2008, and July , 2010, 43 patients were randomly assigned to BM-MSCs group (n=21)or control group(n=22) and followed up for 12 months. LV ejection fraction increased from baseline to 12 months in the BM-MSCs group and control group ( mean baseline-adjusted BM-MSCs treatment differences in LV ejection fraction 4.8% (SD 9.0) and mean baseline-adjusted control group treatment differences in LV ejection fraction 5.8% (SD 6.04) ). After 6 months of follow-up, there was no significant improvement in myocardial metabolic activity in the BM-MSCs group before and after transplantation. however,there was no statistically significant difference between the two groups in the change of LV ejection fraction (p=0.30) and myocardial metabolic activity(p>0.05). We noticed that ,after 12 months of follow-up, except for 1 death and 1 coronary microvascular embolism in the BM-MSCs group, no other events occurred and Alanine transaminase(ALT) and C-reactive protein(CRP) in BM-MSCs group were significantly lower than that in control group. Conclusions: It is unreasonable to speculate that intracoronary transfer of autologous bone marrow MSCs could augment recovery of LV function and myocardial viability after acute myocardial infarction.Trial registration: clinicaltrials,NCT04421274. Registered 06,08,2020- Retrospectively registered, https://register.clinicaltrials.gov/NCT04421274.

scholarly journals Bone marrow mesenchymal stem cells transfer in patients with ST-segment elevation myocardial infarction: single-blind, multicentre, randomized controlled trial

2021 ◽  
Author(s):  
Runfeng Zhang ◽  
Jiang Yu ◽  
Ningkun Zhang ◽  
Wensong Li ◽  
Jisheng Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
General Hospital ◽  
Myocardial Viability ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
Significant Difference ◽  
Lv Ejection Fraction

Abstract Objective Our aim was to evaluate the efficacy and safety of intracoronary autologous bone morrow mesenchymal stem cells (BM-MSCs) transplantation in patients with ST-segment elevation myocardial infarction (STEMI).Methods In this randomized, single-blind, controlled trial, patients with STEMI (aged 39-76 years) were enrolled at 6 centers in Beijing (the People's Liberation Army Navy General Hospital, Beijing Armed Police General Hospital, Chinese People's Liberation Army General Hospital, Beijing Huaxin Hospital, Beijing Tongren Hospital, Beijing Chaoyang Hospital West Hospital). All patients underwent optimum medical treatment and percutaneous coronary intervention, and were randomly assigned in a 1:1 ratio to BM-MSCs group or control group. The primary endpoint was the change of myocardial viability at the 6th month's follow-up and left-ventricular (LV) function at the 12th month's follow-up.The secondary endpoints were the incidence of cardiovascular event, total mortality and adverse event during the 12 months' follow-up. The myocardial viability assessed by single- photon emission tomography (SPECT). The left ventricular ejection fraction was used to assess LV function. All patients underwent dynamic ECG and laboratory evaluations. This trial is registered with ClinicalTrails.gov, number NCT04421274.Results Between March 2008, and July 2010, 43 patients who had underwent optimum medical treatment and successful percutaneous coronary intervention were randomly assigned to BM-MSCs group (n=21)or control group (n=22) and followed up for 12 months. At the 6th month's follow-up, there was no significant improvement in myocardial activity in the BM-MSCs group before and after transplantation. Meanwhile, there was no statistically significant difference between the two groups in the change of myocardial perfusion defect index (p=0.90) and myocardial metabolic defect index (p=0.37). The LV ejection fraction increased from baseline to 12 months in the BM-MSCs group and control group ( mean baseline-adjusted BM-MSCs treatment differences in LV ejection fraction 4.8% (SD 9.0) and mean baseline-adjusted control group treatment differences in LV ejection fraction 5.8% (SD 6.04) ). However, there was no statistically significant difference between the two groups in the change of the LV ejection fraction (p=0.23). We noticed that during the 12 months' follow-up, except for one death and one coronary microvascular embolism in the BM-MSCs group, no other events occurred and Alanine transaminase (ALT) and C-reactive protein (CRP) in BM-MSCs group were significantly lower than that in control group.Conclusions The present study may have many methodological limitations, and within those limitations, we did not identify that intracoronary transfer of autologous BM-MSCs could largely promote the recovery of LV function and myocardial viability after acute myocardial infarction.

scholarly journals Bone marrow mesenchymal stem cells transfer in patients with ST-segment elevation myocardial infarction: single-blind, multicenter, randomized controlled trial

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Runfeng Zhang ◽  
Jiang Yu ◽  
Ningkun Zhang ◽  
Wensong Li ◽  
Jisheng Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
General Hospital ◽  
Myocardial Viability ◽  
Controlled Trial ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
St Segment Elevation ◽  
Significant Difference

Abstract Objective Our aim was to evaluate the efficacy and safety of intracoronary autologous bone marrow mesenchymal stem cell (BM-MSC) transplantation in patients with ST-segment elevation myocardial infarction (STEMI). Methods In this randomized, single-blind, controlled trial, patients with STEMI (aged 39–76 years) were enrolled at 6 centers in Beijing (The People’s Liberation Army Navy General Hospital, Beijing Armed Police General Hospital, Chinese People’s Liberation Army General Hospital, Beijing Huaxin Hospital, Beijing Tongren Hospital, Beijing Chaoyang Hospital West Hospital). All patients underwent optimum medical treatment and percutaneous coronary intervention and were randomly assigned in a 1:1 ratio to BM-MSC group or control group. The primary endpoint was the change of myocardial viability at the 6th month’s follow-up and left ventricular (LV) function at the 12th month’s follow-up. The secondary endpoints were the incidence of cardiovascular event, total mortality, and adverse event during the 12 months’ follow-up. The myocardial viability assessed by single-photon emission computed tomography (SPECT). The left ventricular ejection fraction (LVEF) was used to assess LV function. All patients underwent dynamic ECG and laboratory evaluations. This trial is registered with ClinicalTrails.gov, number NCT04421274. Results Between March 2008 and July 2010, 43 patients who had underwent optimum medical treatment and successful percutaneous coronary intervention were randomly assigned to BM-MSC group (n = 21) or control group (n = 22) and followed-up for 12 months. At the 6th month’s follow-up, there was no significant improvement in myocardial activity in the BM-MSC group before and after transplantation. Meanwhile, there was no statistically significant difference between the two groups in the change of myocardial perfusion defect index (p = 0.37) and myocardial metabolic defect index (p = 0.90). The LVEF increased from baseline to 12 months in the BM-MSC group and control group (mean baseline-adjusted BM-MSC treatment differences in LVEF 4.8% (SD 9.0) and mean baseline-adjusted control group treatment differences in LVEF 5.8% (SD 6.04)). However, there was no statistically significant difference between the two groups in the change of the LVEF (p = 0.23). We noticed that during the 12 months’ follow-up, except for one death and one coronary microvascular embolism in the BM-MSC group, no other events occurred and alanine transaminase (ALT) and C-reactive protein (CRP) in BM-MSC group were significantly lower than that in the control group. Conclusions The present study may have many methodological limitations, and within those limitations, we did not identify that intracoronary transfer of autologous BM-MSCs could largely promote the recovery of LV function and myocardial viability after acute myocardial infarction.

scholarly journals Does left ventricular function predict cardiac outcome in Anderson–Fabry disease?

2020 ◽  
Author(s):  
Letizia Spinelli ◽  
Giuseppe Giugliano ◽  
Antonio Pisani ◽  
Massimo Imbriaco ◽  
Eleonora Riccio ◽  
...  
Keyword(s):  
Adverse Events ◽  
Ejection Fraction ◽  
Fabry Disease ◽  
Adverse Outcome ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Ejection Fraction ◽  
Cardiac Outcome

AbstractIn Anderson–Fabry disease (AFD) the impact of left ventricular (LV) function on cardiac outcome is unknown. Noninvasive LV pressure–strain loop analysis is a new echocardiographic method to estimate myocardial work (MW). We aimed to evaluate whether LV function was associated with outcome and whether MW had a prognostic value in AFD. Ninety-six AFD patients (41.8 ± 14.7 years, 43.7% males) with normal LV ejection fraction were retrospectively evaluated. Inclusion criteria were sinus rhythm and ≥ 2-year follow-up. Standard echocardiography measurements, myocardial mechano-energetic efficiency (MEE) index, global longitudinal strain (GLS) and MW were evaluated. Adverse cardiac events were defined as composite of cardiac death, malignant ventricular tachycardia, atrial fibrillation and severe heart failure development. During a median follow-up of 63 months (interquartile range 37–85), 14 events occurred. Patient age, cardiac biomarkers, LV mass index, left atrium volume, E/Ea ratio, LV ejection fraction, MEE index, GLS and all MW indices were significantly related to adverse outcome at univariate analysis. After adjustment for clinical and echocardiographic parameters, which were significant at univariate analysis, GLS and MW resulted independent predictors of adverse events (p < 0.01). By ROC curve analysis, constructive MW ≤ 1513 mmHg% showed the highest sensitivity and specificity in predicting adverse outcome (92.9% and 86.6%, respectively). MW did not improve the predictive value of a model including clinical data, LV diastolic function and GLS. LV function impairment (both systolic and diastolic) is associated with adverse events in AFD. MW does not provide additive information over clinical features and systolic and diastolic function.

Abstract 3336: Fractional and Coronary Flow Reserve in Prediction of Functional Recovery of Myocardium in Patients with Previous Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Branko Beleslin ◽  
Miodrag Ostojic ◽  
Ana Djordjevic-Dikic ◽  
Vladan Vukcevic ◽  
Sinisa Stojkovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Functional Recovery ◽  
Coronary Flow ◽  
Left Ventricular ◽  
Functional Improvement ◽  
Lv Function ◽  
Previous Myocardial Infarction ◽  
Flow Reserve ◽  
Lv Ejection Fraction

Background: Fractional flow reserve (FFR) may provide clinically useful diagnostic information both in patients (pts) with normal left ventricular (LV) function as well as in pts with previous myocardial infarction (MI). However, the question remains to the relation between improvement of FFR and improvement of LV function in pts with previous MI undergoing percutaneous coronary intervention (PCI). Aim: The aim of the study was to evaluate the relation between FFR and simultaneously evaluated coronary flow reserve by thermodilution (CFRthermo), with functional improvement of LV function in pts with previous MI undergoing PCI. Methods: Study population consisted of 50 pts (mean age 53±8 years; 40 male) with previous MI and significant coronary stenosis in one-vessel CAD (33 LAD, 4 Cx, 13 RCA) undergoing PCI of infarct-related coronary artery. In all pts we have evaluated by single pressure/thermo wire FFR and CFRthermo before and immediately after PCI. In all pts, we have evaluated LV ejection fraction by echo and wall motion score index (WMSI) before and 3 months after PCI. Results: Coronary lesions were successfully treated in all pts with decrease of diameter stenosis from 63±7% to 18±9% (p<0.001). FFR increased significantly (p<0.001) from 0.62±0.15 to 0.91±0.06 after PCI, whereas CFRthermo increased significantly (p<0.01) from 1.5±0.3 to 2.5±0.7. LV ejection fraction increased from 49±6% to 55±8% (p<0.0001), and WMSI decreased from 1.44±0.24 to 1.29±0.29 (p<0.0001). LV functional improvement was observed in 33/50 (66%) of pts. In pts with LV functional recovery in comparison to pts with no recovery there was significant difference in FFR before PCI (0.57±0.15 vs. 0.71±0.11, p=0.001), improvement of FFR during PCI (0.34±0.15 vs. 0.21±0.13, p=0.004), improvement of CFRthermo during PCI (1.2±0.6 vs. 0.6±0.5, p=0.001) and CFRthermo after PCI (2.7±0.7 vs. 2.1±0.6, p=0.008), respectively. Conclusion: Evaluation of FFR and CFRthermo provide significant prognostic information on LV functional recovery in pts with previous MI undergoing PCI. Lower FFR before PCI, higher CFRthermo after PCI, as well as higher improvement of FFR and CFRthermo during PCI are indicative of left ventricular functional improvement in pts with previous MI.

scholarly journals Effect of Ischaemic Postconditioning on Recovery of Left Ventricular Contractile Function after Acute Myocardial Infarction

2012 ◽  
Vol 40 (3) ◽  
pp. 1082-1088 ◽  
Author(s):  
Cm Zhao ◽  
Xj Yang ◽  
Jh Yang ◽  
Xj Cheng ◽  
X Zhao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ejection Fraction ◽  
Wall Motion ◽  
Contractile Function ◽  
Left Ventricular ◽  
Control Group ◽  
Wall Motion Score Index ◽  
Lv Ejection Fraction ◽  
Score Index

OBJECTIVE: This study investigated whether ischaemic postconditioning can improve recovery of myocardial contractile function in acute myocardial infarction patients 1 week and 6 months after angioplasty. METHODS: A total of 62 patients undergoing direct percutaneous coronary intervention after acute myocardial infarction were randomly assigned to receive four episodes of inflation and deflation of the angioplasty balloon in the early reperfusion period (postconditioned group, n = 32), or no additional intervention (control group, n = 30). Two-dimensional size and left ventricular (LV) global and regional contractile functions were then evaluated by echocardiography at 1 week and 6 months after angioplasty. RESULTS: At 1 week, there were no significant differences in left atrial diameter, LV end-diastolic diameter, LV end-diastolic volume, cardiac output, LV ejection fraction or wall motion score index between the two groups. At 6 months, LV ejection fraction was significantly increased and the wall motion score index significantly reduced in the postconditioned group compared with the control group. CONCLUSION: Ischaemic postconditioning can improve long-term LV contractile function 6 months after reperfusion following acute myocardial infarction.

scholarly journals Ultrasound assessment of heart remodelling affected by therapeutic hypothermia and MSC on myocardial infarction model

2020 ◽  
Vol 28 (3) ◽  
pp. 222-240
Author(s):  
M. O. Chyzh ◽  
A. O. Manchenko ◽  
A. V. Trofimova ◽  
I. V. Belochkina
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Therapeutic Hypothermia ◽  
Left Coronary Artery ◽  
Left Ventricular ◽  
Control Group ◽  
Normal Range ◽  
Allogeneic Mscs

Background. Late seeking medical advice, limited number of cardiac surgery hospitals and conservative treatment, which does not seem to be always efficacious, trigger the search for new, more effective mode therapy of acute myocardial infarction (MI). Recently, mesenchymal stromal cells (MSCs) have come into sharp focus of scientists due to the prospects for clinical use. On the other hand, multicenter studies have proved that therapeutic hypothermia (TH) has neuro- and cardioprotective effects, and it is administered as one of the urgent methods in providing primary health care. Purpose. Providing and analyzing ultrasonography (US) of rat hearts with experimental MI in order to determine the nature of heart remodelling under combined use of TH and introducing allogeneic MSCs. Materials and methods. The study involved 90 outbred white rats weighing 240–270 g. Myocardial infarction was reproduced by ligating the descending branch of the left coronary artery on the border of the upper and middle third of the vessel. Therapeutic hypothermia was performed in a cold chamber, 60 minutes long. The local skin temperature of the neck area was maintained at +4 оC, while the rectal and tympanic temperature decreased to + 25 оC. A suspension of allogeneic cryopreserved MSCs of the placenta with a concentration of 1.2 × × 106 cells/ml was administered once intravenously through v. saphena magna. Heart sonography was carried out by means of «Сономед 500» («СПЕКТРОМЕД», Russia) ultrasound scanner in B- and M-mode using a linear sensor 7.5L38 with frequency of 7.5 MHz. Results and discussion. The control group with experimental MI showed significantly suppressed function of the left ventricle (LV). It resulted in decreasing stroke volume (SV) and cardiac output (CO) and on the whole indicated reduced ejection fraction (EF) to 46.04 %, that was 35 % less than the corresponding normal range. According to the values of relative wall thickness (RWT) and left ventricular mass (LVM) on day 7 and day 30 after ligating the left coronary artery, LV remodelling was proceeding via eccentric mode of LV alteration. Therapeutic hypothermia was not able to completely stop the pathophysiological processes associated with coronary ligation. EF was not significantly different from the control group, and was 51.08 ± ± 2.68 %. On day 7 of the experiment, heart remodelling in this group was proceeding according to the normal geometry model, and on day 30 – according to the eccentric model. In spite of the volume overload causing post-infarction extension of the left ventricular cavity, in the group with applying MSCs, on day 7 there was a compensatory increase of the stroke volume, 1.8 times over compared to the group with normal range values and 2.3 over compared to the control group. The ejection fraction was 17 % less than the normal range, but statistically significantly higher than the corresponding indicator of the control group of this observation period. Heart remodelling after applying allogeneic MSCs associated with MI at all stages of observation was proceeding by eccentric LV hypertrophy. Аfter therapeutic hypothermia and applying MSCs associated with experimental myocardial infarction on day 7 and day 30, the group recorded the best values of echo params of LV anatomical structures, indicating no dilatation along with occuring moderate myocardial hypertrophy. The ejection fraction showed the best outcome, i. e. 58.78 %, while LV remodelling was minimal, occurring according to normal heart geometry. Conclusions. Applying echocardiography in rats is a very informative diagnosis method which makes it possible to describe the type of structural and functional remodelling of the myocardium associated infarction at early and late observation stages. The ultrasound study showed that the closest to the normal range was the group of animals exposed to therapeutic hypothermia and MSC transplantation. According to LVM and RWT values, in the rats of that group on day 7 and day 30 of the experiment, LV remodelling was characterized by normal geometry.

Abstract P028: The Effect of Cotransplantation of Human Embryonic Stem Cell--Derived Cardiomyocytes and Mesenchymal Stem Cells on Ventricular Function and Remodeling After Myocardial Infarction in Nude Rats

2011 ◽  
Vol 109 (suppl_1) ◽  
Author(s):  
Wangde Dai ◽  
Mary Kearns-Jonker ◽  
Paul Gerczuk ◽  
Mirja Gunthart ◽  
Nandini Girish ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Stem Cells ◽  
Human Embryonic Stem Cell ◽  
Embryonic Stem ◽  
Saline Group ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
Left Ventriculography ◽  
Nude Rats

We determined whether co-transplantation of human embryonic stem cell-derived cardiomyocytes (hESC-CMs) and mesenchymal stem cells (MSCs) had additive effects on left ventricular (LV) function and remodeling compared with hESC-CMs treatment alone in a rat myocardial infarction model. One week after myocardial infarction induced by left coronary ligation, nude rats received hESC-CMs (n=15), hESC-CMs + MSCs (n=16), hESC-CMs + MSCs transduced to over-express hemeoxygenase 1(HO-1) (n=14), or saline (n=19). At 4 weeks after treatment, LV function was assessed by left ventriculography, echocardiography and Millar catheter. Some hearts were processed for histology. The LV ejection fraction (LVEF) in sham noninfarcted hearts was 78.1±1.8% (n=5) in the nude rat model. LVEF in the 3 cell treated groups (hESC-CMs: 67.6±1.4%; hESC-CMs + MSCs: 67.2±1.6%; and hESC-CMs + MSCs with HO-1: 66.3±1.7%) were comparable, and significantly higher than in the saline group (60.6±1.2%, n=19; p=0.0022). There was a trend for less left ventricular akinesis and dyskinesis (expressed as % of LV circumference) assessed by left ventriculography at 8.96±1.9% in hESC-CMs group, 8.37±1.67% in hESC-CMs + MSCs group and 4.57±1% in hESC-CMs + MSCs with HO-1 group compared to 10.73±1.76% in the control group (p=0.056). There was a nonsignificant trend for LV fractional shortening assessed by echocardiography to be greater in the 3 cell groups (32.1±3.9% in hESC-CMs; 30.2±2% in hESC-CMs + MSCs; 31.0±1.9% in hESC-CMs + MSCs with HO-1) compared to 24.8±2.2% in the saline group (p=0.18). Expansion index reflecting thinning and dilatation of the infarct was significantly worse in the control group at 0.71±0.05 versus the other 3 groups at 0.32±0.05 (p=0.0039). Thus, cell therapy by hESC-CMs alone or combination transplantation of hESC-CMs and MSCs (with or without HO-1) significantly improved LV function assessed by left ventriculography and reduced expansion index. However, co-transplantation of hESC-CMs and MSCs did not provide better functional improvement compared with hESC-CMs treatment alone after left coronary artery occlusion in nude rats over a period of 4 weeks, suggesting that there may be a ceiling effect above which LV function can not further improve after cell therapy.

Abstract 15436: Left Ventricular Ejection Fraction and MACE in Women With Signs and Symptoms of Ischemia: Data From the WISE (Women's Ischemia Syndrome Evaluation)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Stephanie Wu ◽  
Marie Lauzon ◽  
Jenna Maughan ◽  
Leslee J Shaw ◽  
Sheryl F Kelsey ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Major Adverse Cardiovascular Events ◽  
Ventricular Ejection Fraction ◽  
Significant Difference

Background: Relatively high left ventricular ejection fraction (EF) (>65%) in women was recently associated with higher all-cause mortality over 6 years follow-up in the CONFIRM study. We sought to evaluate high EF and major adverse cardiovascular events (MACE) in the Women’s Ischemia Syndrome Evaluation (WISE) study. Methods: The WISE original cohort (enrolled 1996-2000) is a multicenter prospective study of women with suspected ischemic heart disease undergoing clinically indicated invasive coronary angiography. We investigated the relationship between high (>65%) and normal (55-65%) EF and MACE, defined as all-cause death, nonfatal myocardial infarction (MI), stroke and heart failure (HF) hospitalization using Kaplan Meier (KM) and regression analyses. Results: A total of 653 women were included (298 high and 355 normal EF). Mean age was 58±11 years and mean EF was 68±7%. There was no significant difference in MACE by EF group over a 10-year follow-up period (log rank p=0.54, Figure ). When patients were stratified by the presence of obstructive CAD, MACE rates remained similar between high and normal EF. High EF was not associated with stroke or HF but had a lower MI risk (log rank p=0.03, Table ). EF was not associated with MACE in a multivariable regression model. Conclusions: Among women presenting with evidence of ischemia, there was no significant difference in MACE between high and normal EF groups. High EF was associated with a lower risk of myocardial infarction as an individual component of MACE.

scholarly journals P738 Association of galectin-3 and soluble ST2, and their changes, with echocardiographic parameters and development of heart failure after ST-segment elevation myocardial infarction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Tyminska ◽  
A Kaplon-Cieslicka ◽  
K Ozieranski ◽  
M Budnik ◽  
A Wancerz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Ejection Fraction ◽  
St Segment Elevation ◽  
St Segment ◽  
Lv Mass ◽  
Galectin 3 ◽  
Echocardiographic Parameters ◽  
One Year

Abstract Background The occurrence of HF (heart failure) with preserved ejection fraction (HFpEF) has risen significantly over the past decade. Galectin-3 (Gal-3) and soluble ST2 (sST2) are involved in inflammatory processes and fibrosis and might be useful in estimation of the risk of HFpEF development after myocardial infarction (MI).Purpose: To investigate the association of Gal-3 and sST2, and their follow-up changeswith echocardiographic parameters of systolic and diastolic dysfunctionin patients (pts) with ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods:A prospective, observational study, BIOSTRAT (NCT03735719), enrolled 117 pts. Gal-3 and sST2 serum collection and echocardiography were performed twice (during index hospitalization and on a control visit at one-year follow-up). Assessedat baseline and at one-year echocardiographic indices included left ventricular ejection fraction (LVEF), atrial and ventricular size, LV posterior wall and septal thickness, LV hypertrophy based on LV mass index, mitral inflow velocities, and early diastolic tissue velocities at the lateral and medial mitral annulus. Results:Mean baseline concentrations of Gal-3 and sST2 (7.5 and 26.4 ng/mL, respectively) were increased at one-year follow-up (8.5 ng/mL, p &lt; 0.001 and 31.4 ng/mL, p = 0.001, respectively). Fifty of 105 pts (48%) developed HF and 30% of the study population had LVEF &lt;50% at one-year. There were no significant differences between pts with LVEF &lt;50% and ≥50% in terms of baseline, follow-up, nor changes in Gal-3 and sST2 concentrations from baseline to the one-year visit. Gal-3 and sST2 concentrations at baseline, after one-year, and their changes were correlated with echocardiographic parameters. Correlation analysis revealed that higher baseline Gal-3 concentrations correlated inversely only with LV end-diastolic volume at one-year. There were no other significant correlations of baseline, follow-up, nor changes in Gal-3 concentration with echocardiographic parameters. Baseline sST2 values correlated positively with LV end-diastolic diameter, LV end-systolic volume, LV mass index, and inversely with LVEF at one-year, but not with baseline echocardiographic parameters. Changes in sST2 concentration correlated positively only with LVEF at one-year. There were no significant correlations of sST2 concentrations at follow-up with echocardiographic parameters. Only pts with a higher sST2 baseline level had lower LVEF at baseline and after one-year, and pts with higher concentrations of both Gal-3 and sST2 at baseline were more likely to have LV hypertrophy initially and after one-year. There was no clear association of rising biomarkers’ quartiles with other echocardiographic parameters. Conclusions:There was no clear association between both biomarkers and echocardiographic parametersof diastolic dysfunction. Increasing levels of Gal-3 and sST2 do not reflect the HFpEF development in pts after STEMI.

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