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 < 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 <50% at one-year. There were no significant differences between pts with LVEF <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.

scholarly journals Association of Galectin-3 and Soluble ST2, and Their Changes, with Echocardiographic Parameters and Development of Heart Failure after ST-Segment Elevation Myocardial Infarction

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Agata Tymińska ◽  
Agnieszka Kapłon-Cieślicka ◽  
Krzysztof Ozierański ◽  
Monika Budnik ◽  
Anna Wancerz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Primary Endpoint ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Baseline Concentrations ◽  
Galectin 3 ◽  
Echocardiographic Parameters ◽  
One Year

Purpose. To investigate the association of galectin-3 (Gal-3) and soluble ST2 (sST2) and their follow-up changes with the development of heart failure (HF) and echocardiographic parameters of HF (ejection fraction, atrial and ventricular size, left ventricular hypertrophy, e′, and E/e′) in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods. A prospective, observational study, BIOSTRAT (Biomarkers for Risk Stratification After STEMI), enrolled 117 patients between October 2014 and April 2017. Gal-3 and sST2 serum collection and echocardiography were performed twice (during index hospitalization and on a control visit at one-year follow-up). The primary endpoint was HF onset at one-year follow-up. Secondary assessments included associations of biomarker concentration with echocardiographic indices of systolic and diastolic dysfunction at baseline and at one year. Results. Mean baseline concentrations of Gal-3 and sST2 (7.5 and 26.4 ng/mL, respectively) were significantly increased at one-year follow-up (8.5 ng/mL and p<0.001 and 31.4 ng/mL and p=0.001, respectively). Patients who reached the primary endpoint (50 patients (48%)) had significantly higher baseline concentrations of both biomarkers and a higher Gal-3 level at one year compared to patients who did not. Both Gal-3 and sST2 were predictors of the primary endpoint in univariate logistic regression analysis, but only Gal-3 remained significant in multivariate analysis. There was no clear association between both biomarkers and echocardiographic parameters. Conclusions. Baseline, but not one-year, changes of Gal-3 and sST2 concentrations may be useful for risk stratification after STEMI. However, only Gal-3 was the independent predictor of HF development at one-year observation. This trial is registered with NCT03735719.

scholarly journals Serum and Echocardiographic Markers May Synergistically Predict Adverse Cardiac Remodeling after ST-Segment Elevation Myocardial Infarction in Patients with Preserved Ejection Fraction

Diagnostics ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 301
Author(s):  
Tamara Pecherina ◽  
Anton Kutikhin ◽  
Vasily Kashtalap ◽  
Victoria Karetnikova ◽  
Olga Gruzdeva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Cardiac Remodeling ◽  
Left Ventricular ◽  
Serum Biomarkers ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Galectin 3 ◽  
Echocardiographic Parameters

Improvement of risk scoring is particularly important for patients with preserved left ventricular ejection fraction (LVEF) who generally lack efficient monitoring of progressing heart failure. Here, we evaluated whether the combination of serum biomarkers and echocardiographic parameters may be useful to predict the remodeling-related outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and preserved LVEF (HFpEF) as compared to those with reduced LVEF (HFrEF). Echocardiographic assessment and measurement of the serum levels of NT-proBNP, sST2, galectin-3, matrix metalloproteinases, and their inhibitors (MMP-1, MMP-2, MMP-3, TIMP-1) was performed at the time of admission (1st day) and on the 10th–12th day upon STEMI onset. We found a reduction in NT-proBNP, sST2, galectin-3, and TIMP-1 in both patient categories from hospital admission to the discharge, as well as numerous correlations between the indicated biomarkers and echocardiographic parameters, testifying to the ongoing ventricular remodeling. In patients with HFpEF, NT-proBNP, sST2, galectin-3, and MMP-3 correlated with the parameters reflecting the diastolic dysfunction, while in patients with HFrEF, these markers were mainly associated with LVEF and left ventricular end-systolic volume/diameter. Therefore, the combination of the mentioned serum biomarkers and echocardiographic parameters might be useful for the prediction of adverse cardiac remodeling in patients with HFpEF.

scholarly journals Myocardial Work and long-term prognosis in patients after ST-segment elevation acute myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Timoteo ◽  
L Moura Branco ◽  
A Galrinho ◽  
T Mano ◽  
P Rio ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Global Longitudinal Strain ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
All Cause Mortality ◽  
Elevation Acute Myocardial Infarction

Abstract Background Left ventricular (LV) global longitudinal strain has demonstrated incremental prognostic value over LV ejection fraction (LVEF) in patients with ST-segment-elevation acute myocardial infarction. However, LV global longitudinal strain (GLS) does not take into consideration the effect of afterload. Myocardial work (MW) by speckle-tracking echocardiography integrates blood pressure measurements (afterload) with LV GLS and it has been recently demonstrated that Global Work Efficiency (GWE) is associated with long-term all-cause mortality. It remains to be demonstrated if MW indices are associated with hard cardiovascular endpoints. The present study aimed to investigate the prognostic value of global LV MW obtained from pressure-strain loops with echocardiography in patients with ST-segment-elevation myocardial infarction. Methods A total of 100 consecutive ST-segment-elevation myocardial infarction patients (mean age, 61±12 years; 75% men) that survived to discharge were retrospectively analysed. LVEF, GLS and all LVMW indices were measured by transthoracic echocardiography before discharge (4.6±2.0 days after admission). All patients had at least a two-year follow-up (mean follow-up of 833±172 days). Outcomes: all-cause mortality, major acute cardiovascular events (a composite of cardiovascular mortality, myocardial infarction, stroke, unplanned cardiovascular admission) and heart failure hospitalization. Results In the two-year follow-up, 6 patients died, there were 17 patients with MACE, and 3 patients were hospitalized with heart failure. We confirmed that for all-cause mortality, GWE showed higher discrimination, compared to GLS (Table 1), with a cut-off of 83% (log-rank &lt;0,001). For MACE, the performance of all methods is suboptimal, with an AUC &lt;0.65 for all variables, except for GLS. For heart failure admission, performance is slightly better, but GLS is still the better parameter to predict this event. Conclusions LVGWE is a better predictor of all-cause mortality compared to GLS, but MW indices failed to demonstrate a prognostic impact in long-term cardiovascular events. Prospective studies are warranted to confirm this finding. FUNDunding Acknowledgement Type of funding sources: None. Table 1

scholarly journals A Multivariate Model to Predict Chronic Heart Failure after Acute ST-Segment Elevation Myocardial Infarction: Preliminary Study

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1925
Author(s):  
Valentin Elievich Oleynikov ◽  
Elena Vladimirovna Averyanova ◽  
Anastasia Aleksandrovna Oreshkina ◽  
Nadezhda Valerievna Burko ◽  
Yulia Andreevna Barmenkova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Multivariate Model ◽  
Diagnostic Efficiency ◽  
St Segment Elevation ◽  
Second Stage ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

A multivariate model for predicting the risk of decompensated chronic heart failure (CHF) within 48 weeks after ST-segment elevation myocardial infarction (STEMI) has been developed and tested. Methods. The study included 173 patients with acute STEMI aged 51.4 (95% confidence interval (CI): 42–61) years. Two-dimensional (2D) speckle-tracking echocardiography (STE) has been performed on the 7th–9th days, and at the 12th, 24th, and 48th weeks after the index event with the analysis of volumetric parameters and values for global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS). A 24-h ECG monitoring (24 h ECG) of the electrocardiogram (ECG) to assess heart rate turbulence (HRT) has been performed on the 7th–9th days of STEMI. The study involved two stages of implementation. At the first stage, a multivariate model to assess the risk of CHF progression within 48 weeks after STEMI has been built on the basis of examination and follow-up data for 113 patients (group M). At the second stage, the performance of the model has been assessed based on a 48-week follow-up of 60 patients (group T). Results. A multivariate regression model for CHF progression in STEMI patients has been created based on the results of the first stage. It included the following parameters: HRT, left ventricular (LV) end-systolic dimension (ESD), and GLS. The contribution of each factor for the relative risk (RR) of decompensated CHF has been found: 3.92 (95% CI: 1.66–9.25) (p = 0.0018) for HRT; 1.04 (95% CI: 1.015–1.07) (p = 0.0027) for ESD; 0.9 (95% CI: 0.815–0.98) (p = 0.028) for GLS. The diagnostic efficiency of the proposed model has been evaluated at the second stage. It appeared to have a high specificity of 83.3%, a sensitivity of 95.8%, and a diagnostic accuracy of 93.3%. Conclusion. The developed model for predicting CHF progression within 48 weeks after STEMI has a high diagnostic efficiency and can be used in early stages of myocardial infarction to stratify the risk of patients.

Pitavastatin Combined with Ezetimibe Treatment was an Effective Approach to Non-IRA Lesion of ST-segment Elevation Myocardial Infarc-tion Patients with Primary Percutaneous Coronary Intervention

2020 ◽  
Vol 21 ◽  
Author(s):  
Bo Zhao ◽  
Guang Ping Li ◽  
Jian Jun Peng ◽  
Li Hui Ren ◽  
Li Cheng Lei ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Gensini Score ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
One Year

Objective: ST-segment elevation myocardial infarction (STEMI) patients with the multivessel disease have distinctive plaque characteristics in non-IRA lesions. Intensive statin therapy was a potential approach to treat STEMI patients with the non-IRA disease. However, there is still poor evidence about the therapeutic effect. In this study, we have evaluated the detailed therapeutic effect of statin plus ezetimibe intensive therapy. Method: For STEMI patients with non-IRA disease undergoing primary percutaneous coronary intervention (PCI), 183 control STEMI patients without non-IRA disease undergoing primary PCI, and 200 STEMI patients with non-IRA disease undergoing primary PCI were introduced into this study. 200 STEMI patients with non-IRA disease undergoing primary PCI were divided into Normal group, Intensive group, Normal & Combined group, and Intensive & Combined group. The baseline information for each participant was recorded. Meanwhile, the physiological and biochemical indicators of each member with different treatments were collected after one-year follow-up. Result: For STEMI patients with non-IRA disease undergoing primary PCI, no differences could be detected in multiple indexes such as OCT examination results, age, stroke, etc. However, diabetes mellitus, smoking, and coronary Gensini score were different between different groups (P<0.05). After one year follow-up, cholesterol, low-density lipoprotein, coronary Gensini score, thin-cap fibroatheroma, length of non-infarcted arterial lesions, non-infarct artery lesion range, myocardial infarction again, and revascularization again were significantly different between different groups (P<0.05). Conclusion: The results mentioned above suggested that pitavastatin combined with ezetimibe was an effective approach to STEMI patients with non-IRA disease undergoing primary PCI. The results obtained in this study have provided a novel way for the treatment of STEMI patients with non-IRA disease undergoing primary PCI.

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