Abstract P3025: Prevalence Of Distinct Regional Wall Motion Abnormalities Among STEMI Patients Of North Indian Origin

Abstract

Background: Causal mechanisms and specific consequences of heart failure (HF) with preserved ejection fraction (HFpEF) are unknown. We compared the EF of ST-elevation myocardial infarction (STEMI) patients with the regional wall motion abnormalities (RWMA). Methods: 2D ECHO data in STEMI patients (n=217) was analyzed for HF with reduced systolic dysfunction (HFrEF), HFpEF, and RWMA. Inclusion: Patients with ≥50% stenosis and hypertension. Exclusion: S epticemia and malignancy patients. Results: Among 217 STEMI subjects, n=102 had either preserved or significantly increased ejection fraction (45-65%), indicating that >47% of them were devoid of systolic dysfunction. The other two major groups were the subjects with moderately abnormal systolic dysfunction (HF r EF; EF >31-42%) and severely abnormal dysfunction (HF r EF; EF <30%). Over 50% of the subjects with HF p EF had basal-septum and inferior wall motion abnormalities, while the rest had apical septum, LAD territory and posterior wall impairments. Four patients displayed signs of mid-septal and anterior wall issues. While most of the HFrEF patients displayed wall motion defects in multiple regions, <10 patients showed anterior wall motion abnormality. Severe HFrEF subjects (n=12) displayed global (all regions) motion defects, which contributes to end-stage heart disease. The RWMA seem to be unique for HFrEF and HFpEF among the STEMI patients. Conclusion: Results indicate that STEMI patients could be sub-grouped into both HF r EF and HF p EF. Further investigation into region-specific rate of remodeling, effect of lifestyle, food habits and pharmacological interventions will aid in improving clinical outcomes.