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Clinical significance of myocardial work parameters after acute myocardial infarction. | LitMetric

AI Article Synopsis

  • The study examines the prognostic significance of myocardial work parameters in patients after experiencing an acute myocardial infarction (AMI).
  • A total of 244 patients were monitored for major cardiac events after receiving specialized care, with findings indicating that those who experienced events had worse overall heart function and were generally older.
  • Specifically, the global work efficiency (GWE) was identified as a crucial measure, with a GWE below 91% indicating a significantly increased risk for major events, making it a valuable tool for assessing post-AMI patient risk.

Article Abstract

Aims: To investigate the additional prognostic value of myocardial work (MW) parameters following acute myocardial infarction (AMI).

Methods And Results: Between 2018 and 2020, 244 patients admitted in the cardiac intensive care unit in Lille University Hospital for AMI were included. One-month following AMI, comprehensive transthoracic echocardiography (TTE) was performed to assess parameters of myocardial function. Patients were then followed for major events (ME): cardiovascular death, heart failure, and unplanned coronary revascularization. At 1-month, half of the population was symptomatic (NYHA ≥ II), and medical therapy was almost optimized (angiotensin-converting enzyme inhibitor/angiotensin 2 receptor blocker in 95.5%, beta-blockers in 96.3%, DAPT in 94.7%, and statins in 97.1%). After a median follow-up of 681 (interquartile range: 538-840) days, ME occurred in 26 patients (10.7%). Patients presenting ME were older (65.5 ± 14.2 vs. 58.1 ± 12.1years,  = 0.005) with a higher prevalence of hypertension (65.4 vs. 36.2%,  = 0.004), more impaired left ventricular (LV) function as assessed by LV ejection fraction ( = 0.07), global longitudinal strain ( = 0.03), or MW parameters [ = 0.01 for global work efficiency (GWE)], and greater LV and left atrium dilatations ( = 0.06 for left ventricular end-diastolic volume index and  = 0.03 for left atrial volume index). After adjustment, GWE was the only TTE parameter independently associated with long-term occurrence of ME ( = 0.02). A GWE value <91% was selected to identify patients at higher ME risk (hazard ratio: 95% confidence interval) = 2.94 (1.36-6.35),  = 0.0041).

Conclusion: Lower GWE at 1 month after AMI is independently associated with higher ME rates. A GWE <91% can improve the post-AMI patient risk stratification.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242079PMC
http://dx.doi.org/10.1093/ehjopen/oeac037DOI Listing

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