Artery Research

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Volume 16, Issue C, December 2016, Pages 78 - 79

12.8 VENTRICULAR-ARTERIAL UNCOUPLING DOES NOT DEPEND ON ARTERIAL ELASTANCE AFTER MYOCARDIAL INFARCTION

Authors
Elena Zharikova, Svetlana Villevalde, Zhanna Kobalava
Peoples Friendship University of Russia, Moscow, Russia
Available Online 24 November 2016.
DOI
10.1016/j.artres.2016.10.106How to use a DOI?
Abstract

Objective: Ventricular remodeling may occur following myocardial infarction (MI) of the left ventricle (LV) and such remodeling has been shown to be correlated with increased patient morbidity and mortality. It is important to estimate the likelihood of remodeling from the state of the infarcted LV. The aim of the study was to assess the ventricular-arterial coupling (VAC) in patients with ST segment elevation (STEMI) and non ST segment elevation MI (NSTEMI) treated with percutaneous coronary intervention (PCI).

Methods: In 93 patients with acute coronary syndrome and PCI (70% male, age 61.5±10.1 years (M±SD), 57 (61.3%) with STEMI, smokers 25%, arterial hypertension 20.4%, blood pressure 129±6/82±7 mmHg) 2-dimentional echocardiography was performed to assess arterial elastance (Ea) and end-systolic LV elastance (Ees) on admission and in 4 weeks. VAC was assessed as the ratio Ea/Ees.

Results: Baseline LV ejection fraction (LVEF) was 47.4±4.3%, E/A 0.95±0.18, Ea 1.9±0.3 mmHg/ml/m2, Ees 2.1±0.4 mmHg/ml/m2, VAC 0.89±0.1. At baseline all patients had LVEF >40% and VAC in optimal range. In 4 weeks after PCI VAC >1.2 (upper optimal level) was revealed in 19% of patients with STEMI and 44% with NSTEMI. In patients with achieved VAC >1.2 Ees (from 2.1±0.4 to 1.5 ±0.3 mmHg/ml/m2, p <0.001), stroke work (SW) (from 6585±1059 to 6919±2131 mmHg*ml/m2, p <0.05), potential energy (PE) (from 1976±371 to 3025±1127 mmHg*ml/m2, p <0.001), pressure-volume area (PVA) (from 6647±1060 to 6977±2136 mmHg*ml/m2, p <0.001), LV work efficiency (SW/PVA) (from 78 to 89%, p<0.001) significantly decreased while Ea (1.9±0.3 and 2.1±0.4 mmHg/ml/m2, p >0.05) did not change. In patients with VAC in optimal range in 4 weeks Ees decreased from 2.3±0.3 to 2.1±0.4 mmHg/ml/m2 (p<0.001), Ea (from 1.87±0.29 to 1.64±0.17 mmHg/ml/m2, p<0.001) and VAC (from 0.82±0.12 to 0.81±0.19, p<0.04) did not change.

Conclusions: Impairment of functioning of cardio-vascular system assessed by increased value of VAC >1.2 was revealed in 30% of patients with acute coronary syndrome. Increase of VAC is associated predominantly with decrease of Ees and LV work efficiency (SW/PVA). Increased VAC index >1.2 indicating LV-arterial uncoupling may be an early marker of unfavorable cardiac remodeling.

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<Previous Article In Issue
Next Article In Issue>
Journal
Artery Research
Volume-Issue
16 - C
Pages
78 - 79
Publication Date
2016/11/24
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2016.10.106How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Elena Zharikova
AU  - Svetlana Villevalde
AU  - Zhanna Kobalava
PY  - 2016
DA  - 2016/11/24
TI  - 12.8 VENTRICULAR-ARTERIAL UNCOUPLING DOES NOT DEPEND ON ARTERIAL ELASTANCE AFTER MYOCARDIAL INFARCTION
JO  - Artery Research
SP  - 78
EP  - 79
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.106
DO  - 10.1016/j.artres.2016.10.106
ID  - Zharikova2016
ER  -