Предикторна цінність ожиріння у хворих з інфарктом міокарда з елевацією сегмента ST

Abstract

The aim – to determine predictors of pathological left ventricular (LV) remodeling in patients with ST-segment elevation myocardial infarction (STEMI) with obesity. Materials and methods. Retrospective cohort study was performed. 111 patients that were hospitalized in the intensive care unit from January 2018 to February 2021 were involved to the study. TIMI-3 flow was restored in all 111 patients. Early cardiac postinfarction pathological remodeling was defined as left ventricular ejection fraction (LVEF) < 50 % and/or Е/е’ ≥ 13; LV diastolic dysfunction was defined as LVEF ≥ 50 % and/or Е/е’ < 13 units. Echocardiography was performed during hospitalization. Also there were determine weight, fat content, visceral fat ratio, skeletal muscle content, daily metabolism, body mass index (BMI).Results and discussion. Patients were divided into two subgroups – 49 patients with obesity (BMI ≥ 30 kg/m2) and 62 – without obesity (BMI < 30 kg/m2). The prognostic value of various factors for pathological remodeling of left ventricle (LV) was studied in patients with STEMI with and without obesity. Pathological remodeling was assessed as systolic – with reduced LFEF < 50 %, and diastolic – with E/e’ < 13. It was found that multivascular injury is more important for the deve­lopment of LV remodeling in patients with LVEF < 50 % regardless of diastolic function. Visceral fat leads to LV remodeling due to diastolic dysfunction.Conclusion. The predictor value of visceral fat is important for predicting early remodeling associated with isolated diastolic dysfunction in patients with STEMI.