Correlation between novel echocardiographic indices and biomarkers of myocardial injury in patients with NSTEMI

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction / Purpose The extent of myocardial injury is a prognostic factor in patients with myocardial infarction presenting without persistent ST elevation (NSTEMI). The purpose of this study was the assessment of possible correlation between novel echocardiographic indices and biomarkers of myocardial injury in patients with NSTEMI and normal left ventricular ejection fraction (LVEF). Methods Patients with NSTEMI (18 to 80 years old) who were examined at the echocardiography laboratory of our general hospital, from May 2021 until August 2022, were enrolled in this study. All patients had no former history of cardiac disease or other significant comorbidities, and they all had LVEF ≥55% and normal wall motion score index. After coronography all of them were diagnosed with significant coronary artery disease. Among the novel echocardiographic indices, global longitudinal strain (GLS), and the parameters of myocardial work, global work index (GWI), global constructive work (GCW), global wasted work (GWW) και global work efficiency (GWE) were examined. The biomarkers were maximum high sensitive troponin I (hsTNI) during hospitalization, creatine phosphokinase (CPK) and its myocardial isoenzyme (CK-MB). Correlation between the variables was examined with Spearman method, and a p value <0.05 was considered statistically significant. Results In this study 34 patients with NSTEMI (26 males), of mean age 60.1 years (SD 10.5 years) participated. Median |GLS| was 17.9%, GWI 1957.7mmHg%, GCW 2231.0mmHg%, GWW 141.7mmHg% and GWE 92.2% (Table 1). As for the biomarkers, median maximum hsTNI value was 1718.0ng/l, CPK 172.0U/l and CK-MB 31.0U/l. A negative correlation was shown between hsTNI and GWE (Spearman’s rs =−0.515, p = 0.002), and a positive between hsTNI and GWW (Spearman’s rs =−0.426, p = 0.013). Also, CK-MB values had a negative correlation with |GLS| (Spearman’s rs =−0.411, p = 0.017) and GWE (Spearman’s rs =−0.425, p = 0.014). No correlation was found between CPK and the echocardiographic indices. Conclusion Novel echocardiographic indices were correlated with biomarkers of myocardial injury in patients presenting with NSTEMI and normal LVEF.