Abstract
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.
Highlights
Chronic heart failure (CHF) has become a major public health problem of the 21st century, significantly reducing the life potential of the population worldwide
The following factors for CHF progression have been established according to the univariate regression analysis of data from 113 segment elevation myocardial infarction (STEMI) patients: pathological values of TO
heart rate turbulence (HRT), brain natriuretic peptide (BNP) level, end-systolic dimension (ESD), global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) values obtained on the 7th–9th days of STEMI (Table 1)
Summary
Chronic heart failure (CHF) has become a major public health problem of the 21st century, significantly reducing the life potential of the population worldwide. Major causes of CHF are arterial hypertension and coronary heart disease [1,2]. A combination of both diseases occurs in more than half of patients [2,3]. Annual costs of treating CHF patients grow progressively due to an increase in the life expectancy of patients [4,5]. According to a large-scale meta-analysis [5], a fiveyear life expectancy in patients with CHF has increased by 59.7% as compared to the. Improvement of the quality of care and expanding the range of drugs after severe cardiovascular events help to maintain the quality of life of patients at an acceptable level for a long period of time. The financial aspect of this issue is rather burdensome [4,5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
