THE CLINICAL COURSE OF MYOCARDIAL INFARCTION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH PULMONARY HYPERTENSION

2020 ◽  
pp. 64-68
Author(s):  
Gordienko A.V. ◽  
Men’shikova A.N. ◽  
Sotnikov A.V.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Clinical Course ◽  
Comparative Assessment ◽  
Study Group ◽  
Routine Examination ◽  
Group Iii ◽  
Appropriate Treatment ◽  
Level Group

Relevance. Pulmonary hypertension (PH) negatively affects the prognosis of myocardial infarction (MI). Aim. To evaluate MI clinical features (CF) in men under 60 years old (y.o.) with PH, arising during MI to improve pre-vention and outcomes. Material and methods. The study included men 19-60 y.o. with MI and various dynamics of mean pulmonary artery pressure (MPAP), determined by echocardiography (A. Kitabatake) in first 48 hours (1) and completion of third week (2). Patients were divided into four groups: studied (I) included 67 patients (mean age 50.4±7.1 y.o) with PH (MPAP2 25 and more mm Hg) and normal of MPAP1 level. Group II included patients with a normal MPAP in both phases of study (70; 52.1±6.6 y.o); group III – with elevated MPAP at both study points (149; 51.2±5.5 y.o) and IV – with in-creased MPAP1 and normal MPAP2 (61, 50.5±6.8 y.o). A comparative assessment of the MI CF frequency in selected groups were performed. Results. The study group occupied intermediate place frequency in medical history presence: coronary heart disease (I: 59.5; II: 61.4; III: 63.6 and IV: 48.9%; p = 0.04), chronic heart failure (CHF) (35.7 ; 34.1; 51.1 and 24.5%, respec-tively; p=0.001), repeated (45.2; 42.0; 47.3 and 29.8%) and early recurrent (3.6; 3.4 ; 6.0 and 3.2%; pIII-IV=0.006) MI, Q-MI (44.0; 35.2; 58.7 and 56.4; p=0.001), anginal MI phenotype (75.0; 74.7; 54.3 and 77.7%; p˂0.0001) and acute HF (ACF) (45,2; 36,8; 50,5 и 48,9%; р=0,002). No pulmonary edema was detected in it (p˂0.0001). Conclusions. Men under 60 y.o. with PH resulting from MI occupy an intermediate place in frequency of complica-tions, ACF and CHF in first 56 days of MI during routine examination compared with other MPAP dynamics patients. This confirms the need for additional verification of PH genesis for the appropriate treatment.

THE PULMONARY CIRCULATION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH PULMONARY HYPERTENSION, DEVELOPED DURING MYOCARDIAL INFARCTION

2020 ◽  
pp. 31-35
Author(s):  
Men’shikova A.N. ◽  
Goncharov S.A. ◽  
Gordienko A.V.
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Hypertension ◽  
Normal Level ◽  
Pulmonary Circulation ◽  
Comparative Assessment ◽  
Pulmonary Resistance ◽  
Group Iii ◽  
The Third ◽  
Group Ii ◽  
Observation Period

Relevance. Formation of pulmonary hypertension (PH) in myocardial infarction (MI) remains poorly understood. Aim. To evaluate changes in pulmonary circulation indicators (PCI) in men under 60 years old (y.o) with PH that is developing in subacute MI period to improve understanding of developmental options and prevention. Material and methods. The study included men aged 19-60 y.o. with MI and various dynamics of mean pulmonary ar-tery pressure (MPAP), determined by echocardiography (A. Kitabatake) in the first 48 hours (1) and completion of third week (2) of MI. Patients were divided into four groups: studied (I) included 84 patients (mean age 50.4±7.1 y.o) with PH (MPAP2 25 and more mm Hg) and normal level of MPAP1. Group II included patients with a normal level of MPAP in both phases of the study (88 men, 52.1±6.6 y.o); group III – with elevated levels of MPAP at both points of study (184 men, 51.2±5.5 y.o) and IV – with increased levels of MPAP1 and normal levels of MPAP2 (94 men, 50.5±6.8 y.o). A comparative assessment of PCI in selected groups was performed. Results. In first 48 hours of MI, the minimum values of MPAP (I: 21.9±3.3; II: 20.3±2.5; III: 39.0±11.2 (mm Hg)) and total pulmonary resistance (TPR) ) (I: 380.0±171.0; II: 306.8±136.3; III: 616.0±279.8 (dyn×sec×cm-5)) were noted in group II, and the maximum - in III (p˂0.0001). When considering their dynamics at the end of the third week of MI, MPAP increased in I (39.5%; p˂0.0001), decreased in III (16.0%; p˂0.0001) and IV groups (42.9%; p˂0.0001). TPR decreased in II (12.1%), III (28.6%) and IV (54.2%) groups (p ˂0.0001). Conclusions. The study group is distinguished by unfavorable changes in PCI during observation period, in contrast to other groups, which confirms expediency of assessing dynamics of these parameters as possible marker of negative prognosis for PH.

MANIFESTATIONS OF HEART INSUFFICIENCY IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION COMPLICATED WITH ACUTE KIDNEY DAMAGE

2021 ◽  
pp. 120-127
Author(s):  
Golikov A.V. ◽  
Reiza V.A. ◽  
Tassybayev B.B. ◽  
Gordienko A.V.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Absolute Risk ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Winter Period ◽  
Study Group ◽  
Type I

Relevance. Acute kidney injury in myocardial infarction worsens its prognosis, including due to the development of chronic heart failure. Moreover, most of the data was obtained for patients over 60 years old. Aim. To evaluate the features of the heart failure manifestations in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative analysis of the heart failure main manifestations frequency in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of their impact on the risk of chronic heart failure development in acute kidney injury (ANOVA) was performed. Results. The study group (4.0%) differed from the control (21.8%) in a lower frequency of acrocyanosis (p = 0.03) and liver enlargement (8.0 and 25.7%; respectively; p = 0.046) at the end of the eighth week diseases. The main risk markers of the chronic heart failure development in study group were: winter period of the year (absolute risk: 94.1%; relative - 3.76; p = 0.0003), respiratory infections 2-3 times a year (absolute risk: 81.8%; p = 0.003), left ventricular myocardial mass index1 ≥ 173.3 g/m2 (absolute risk: 100%; p = 0.008) and mean arterial pressure1 ≥ 120 mm Hg (absolute risk: 100%; relative - 1.88; p = 0.01). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by a higher incidence of chronic heart failure. The listed above values of the different predictors should be used in the formation of the high-risk groups for the chronic heart failure in acute kidney injury development, as well as for prognostic modeling.

scholarly journals Association of High Sensitive C - Reactive Protein with Severity of the Left Ventricular Systolic Dysfunction in Acute Anterior ST Elevation Myocardial Infarction

2018 ◽  
Vol 44 (2) ◽  
pp. 71-76
Author(s):  
Aparna Rahman ◽  
Abdul Wadud Chowdhury ◽  
Lutfur Rahman Khan ◽  
Khandkar Md. Nurus Sabah ◽  
Mohammad Gaffar Amin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
C Reactive Protein ◽  
Group Iii ◽  
Reactive Protein ◽  
St Elevation ◽  
Hs Crp

High Sensitive C-reactive protein (hs- CRP) is an established risk marker in coronary artery disease. It is a marker of inflammation activated early after Acute Myocardial Infarction (AMI) and its quantity depends upon extent of myocardial damage. Release of inflammatory marker occur after acute myocardial infarction leading to cardiac remodeling which clinically manifests as Heart failure (HF). Heart failure is a common complication after acute anterior myocardial infarction (AMI). The prevalence of post-infarct Left Ventricular Systolic Dysfunction (LVSD) ranges from 27 to 60 % and half of patients having early post-infarct LVSD subsequently develop chronic heart failure. The purpose of this study is to show association between hs-CRP with LVSD in AMI and early detection of HF. This was a cross-sectional analytical study in which hs-CRP was done among all the study subjects between 24-48 hours after onset of AMI. The study population was categorized into groups I, II, II according to the lowest to highest hs-CRP level. Transthoracic echocardiography was done between 24-48 hours of anterior ST Elevation Myocardial Infarction (STEMI). Then LVSD was assessed between those three groups and searched for association. Severely reduced ejection fraction (EF) was found in patients of group III (highest hs-CRP tertile) only. Severe and moderately reduced EF and FS was found significantly more in group III and II than group I (mid and lowest hs-CRP tertile) (p<0.001). High level of hs-CRP in patient of acute anterior STEMI patients was associated with moderate to severe reduction in EF and Fractional Shortening (FS).  So hs- CRP may be a prognostic marker in acute anterior STEMI complicating LVSD and early management would improved the short and long term prognosis.

scholarly journals Gender features of structural and functional changes of the heart and levels of copeptin and NTproBNP in patients with acute Q-myocardial infarction in the presence of pulmonary hypertension

2021 ◽  
Vol 23 (4) ◽  
pp. 480-484
Author(s):  
V. D. Syvolap ◽  
Ya. V. Zemlianyi ◽  
D. A. Lashkul
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Functional Class ◽  
City Council ◽  
Enzyme Linked Immunosorbent Assay ◽  
Functional Changes ◽  
Gender Features

The aim. To evaluate the gender features of structural and functional changes in the heart and levels of copeptin and NTproBNP in patients with acute myocardial infarction (AMI) with concomitant pulmonary hypertension (PH). Materials and methods. 74 patients with AMI and concomitant PH who were treated in the intensive care unit and emergency cardiology for patients with myocardial infarction of the Municipal Non-Profit Enterprise “City Hospital of Emergency and Ambulance” of Zaporizhzhia City Council were examined. The patients were divided into two groups: the first group consisted of 42 male patients (mean age 71.06 ± 2.21 years) and 32 female patients (mean age 76.41 ± 2.32 years). All the patients were examined in the first three days by two-dimensional echocardiography on a device MyLab50 (“Esaote”, Italy). The serum levels of kopeptin and NTproBNP were determined by enzyme-linked immunosorbent assay using a set of reagents Elabscience (USA). Results. There was a trend towards a predominantly anterior AMI in the group of men and lower AMI – in the group of women. Individuals with functional class III and IV heart failure predominated (76.1 %) among the men with AMI and PH. At the same time, there were significantly more persons with III and IV functional class in the group of men than in the group of women (P < 0.05). There was a significant diastolic left ventricular posterior wall thickening in women compared to men (8.4 %; P < 0.05) and a tendency to diastolic interventricular septal thickening in females. There was an upward trend in end-systolic and end-diastolic sizes in the group of men compared to women; however, the differences did not reach the required level of significance. Evaluation of serum copeptin and NTproBNP in patients with AMI and PH revealed significantly higher levels of these indicators in the group of men compared to women (P < 0.05). Conclusions. Men with AMI and PH had more severe heart failure compared to women due to the predominance of patients with functional classes III and IV. Women with AMI and PH demonstrated predominantly concentric type of remodeling in the form of significantly thickened LV posterior wall and the tendency to increase interventricular septum wall thickness, and eccentric hypertrophy in the form of LV dilatation prevailed in men. Men with AMI and PH had significantly higher serum copeptin and NTproBNP levels compared to women.

scholarly journals Hospital admission time and acute myocardial infarction outcomes in elderly patients from Central Asia

2012 ◽  
Vol 11 (2) ◽  
pp. 53-56
Author(s):  
A. G. Nikishin ◽  
R. D. Kurbanov ◽  
M. M. Pirnazarov
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Elderly Patients ◽  
Hospital Admission ◽  
Central Asia ◽  
Clinical Course ◽  
St Segment Elevation ◽  
Admission Time ◽  
St Segment

Aim. To identify the specifics of acute myocardial infarction (AMI) clinical course and to study the association between clinical outcomes and hospital admission time among elderly patients from Central Asia. Material and methods. In total, 508 AMI patients were divided into the main group (MG), which included 298 men and women aged over 65 years, and the control group (CG; n=210). The analysed parameters included mean time between AMI onset and hospital admission; percentage of patients hospitalised within first 6 hours; percentage of patients administered streptokinase; streptokinase effectiveness; clinical course of AMI; and in-hospital outcomes. Results. Mean hospital admission time was significantly higher in the MG, compared to the CG: 1220±165 vs. 977±88 minutes (p<0,05). Out of 188 MG patients with ST segment elevation, thrombolytic therapy (TLT) was administered to 14,3 %; in the CG (149 patients with ST segment elevation), the respective percentage was 25,5 %. Clinical course of AMI was similar in both groups. However, the MG was characterised by a significantly higher risk of death (9,4 % vs. 2,86 %; F=0,001; OR 3,53, 95 % CI 1,43—8,67), acute heart failure (33,89 % vs. 21,9 %; F=0,001; OR 1,83, 95 % CI 1,22—2,74), or chronic heart failure (41,31 % vs. 24,76 %; F=0,000; OR 2,62, 95 % CI 1,78—3,86). Conclusion. Elderly patients faced a lower chance of myocardial reperfusion, due to later hospital admission and lower TLT effectiveness, and, as a result, had a higher risk of heart failure.

scholarly journals Elevated plasma Sirtuin2 level predicts heart failure after acute myocardial infarction

2020 ◽  
Author(s):  
Meili Zheng ◽  
Lei Zhao ◽  
Hao Sun ◽  
Mulei Chen ◽  
Xinchun Yang
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Events ◽  
Left Ventricular Ejection ◽  
Major Adverse Cardiovascular Events ◽  
Low Level ◽  
High Level Group ◽  
High Level ◽  
Level Group

Abstract Background and Objectives: There is currently no evidence regarding the role of plasma Sirtuin2 (SIRT2) level in heart failure after acute myocardial infarction (AMI) yet. This study assessed the relationship between plasma SIRT2 level and AMI, and also investigated the association of plasma SIRT2 level with major adverse cardiovascular events (MACE) and heart failure after AMI. Methods and Results: A total of 129 AMI patients were included in the present study. The major adverse cardiovascular events (MACE) and heart failure were recorded during hospitalization and follow-up (12 months) after discharge. According to the 75th percentile value of plasma SIRT2 level, we divided all the AMI patients into two groups: high level group (plasma SIRT2 level≥109.0pg/ml) and low level group (plasma SIRT2 level <109.0pg/ml). Compared with the low level group, the high level group had higher prercentage of Killip class≥3 (P<0.001), left ventricular ejection fraction(LVEF) <50% (P=0.007) or even <40% (P=0.012), use of breathing machine(P=0.003), and higher plasma brain natriuretic peptide (BNP) level (P=0.006). Multivariate regression analysis showed that there were higher risks of MACE (hazard ratio (HR)=11.20 [95% confidence interval (CI): 3.18-39.52, P<0.001]) and heart failure (HR=27.10 [95%CI 4.65-157.83, P<0.001]) in the high level group. Conclusions: The present study suggested that plasma SIRT2 level is a promising biomarker to predict heart failure and MACE after AMI.

scholarly journals The effect of the presence of metabolic syndrome criteria on the post-infarction course in patients with acute myocardial infarction with ST-segment elevation

2020 ◽  
Vol 27 (3) ◽  
pp. 60-72
Author(s):  
O. V. Shumakov ◽  
O. M. Parkhomenko ◽  
O. V. Dovhan ◽  
O. S. Gurjeva
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Metabolic Syndrome ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Clinical Course ◽  
Matching Criteria ◽  
Group 1

The aim – to assess the additional prognostic information of metabolic syndrome (MS) components in groups of patients with acute myocardial infarction with segment elevation ST (STEMI), equalized in terms of commonly used acute coronary syndrome (ACS) risk factors. Materials and methods. Retrospective analysis of the 820 cases of STEMI included: evaluation of risk factors according to the scales TIMI, GRACE, PURSUIT, and evaluation of components of the metabolic syndrome at entry (the presence of diabetes mellitus and/or increasing glucose levels > 7 mmol/l, overweight, hypertension, dyslipidemia), as well as the assessment of the indicators of clinical course of hospital period of MI, treatment and results of follow-up of patients, including the information about cases of cardiac death. Results and discussion. Via automated «case-match-control» algorhythm from the basic cohort 2 groups were selected: group 1 (n=41, patients with MS) and group 2 (n=123, patients without MS). Matching criteria included following 13 risk factors: age, height, presence of heart failure, smoking, systemic hypotension at the 1 day of AMI, presence of anterior STEMI, the peak level of the MB-CK and AST, a history of angina and the period of unstable angina before STEMI, the presence of previous MI, baseline heart rate, baseline glomerular filtration rate (CKD-EPI), male gender. Groups were exactly matched by the first 4 matching criteria, and among other criteria maximum mismatch of 3 criteria was allowed (mean mismatch was 1.87 criteria from 13 per pair, and there were no significant differences in groups by each of 13 matching criteria). Otherwise, group 1 was characterized by more severe baseline profile, clinical course of hospital period, but it has the more intensive medical treatment also (including more frequent prescription of ACE inhibitors). According to the follow-up data, patients in group 1 had smaller end-systolic and end-diastolic indexes, more signed improvement in acute heart failure rate, higher heart rate variability and smaller dispersion of repolarisation at the 10th day. Also there was observed a trend toward a lower 3-year mortality (4,9 versus 17,1 %; p=0.05). Conclusions. The presence of MS accompanying STEMI is associated with poorer course of acute period of the disease and, in a contrary, with more favorable course of post-infarction period because of more intensive cardiac therapy in this group of patients.

scholarly journals IMPACT OF COMBORBIDE LOAD ON CLINICAL COURSE OF INFERIOR WALL MYOCARDIAL INFARCTION WITH RIGHT VENTRICULAR INVOLVEMENT

2019 ◽  
Vol 20 (4) ◽  
pp. 63-70
Author(s):  
K. Yu. Glavatskikh ◽  
I. Yu. Lukyanova ◽  
V. I. Shalnev ◽  
I. Yu. Pchelin
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Right Ventricular ◽  
Clinical Course ◽  
Inferior Wall ◽  
Acute Period

The article presents data on the frequency and structure of comorbid pathology in patients with inferior wall myocardial infarction with right ventricular involvement. Its relationship with the clinical course of myocardial infarction in the acute period was studied. It was shown that patients with inferior wall myocardial infarction with right ventricular involvement have a high comorbid load. It was revealed that a more severe course of the acute period of myocardial infarction in these patients was associated with chronic cerebrovascular ischemia, fatty liver, chronic heart failure I–IIa stages, type 2 diabetes mellitus and obesity.  

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