Correlation of new and traditional indicators of myocardial contractility in ST-segment elevation myocardial infarction

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Purpose to assess the relationship of indicators of global myocardial work of the left ventricle (LV) in patients with ST-segment elevation myocardial infarction (STEMI) with hemodynamic and deformation parameters that traditionally characterize the systolic function of the heart. Methods 45 people with primary STEMI were included: 13 women and 32 men aged 38 to 66 years (52.3 ± 7.4). Myocardial infarction was confirmed by ECG, biomarkers (troponin I, CPK-MB) and by the results of coronary angiography. Echocardiography has been performed on the 7-9th day of STEMI using a Vivid GE 95 Healthcare ultrasound scanner (USA). EchoPAC software version 202 (GE Healthcare) has been used. The end-diastolic volume index (EDVi, ml / m2), end-systolic volume index (ESVi, ml / m2), LV ejection fraction (EF,%) have been assessed using the Simpson biplane method. The global longitudinal strain (GLS,%) has been determined using the speckle-tracking echocardiography method. The indicators of myocardial work have been automatically calculated: the index of global myocardial work (GWI, mm Hg%), global constructive work (GCW, mm Hg%), and global wasted work (GWW, mm Hg%), global work efficiency (GWE,%). Statistical data processing has been performed using the Statistica 13.0 software package (StatSoft Inc., USA). Results the average values of the determined parameters were the following: LVEF - 49.4 ± 6.7%, EDVi - 62.8 ± 12.7 ml / m2, ESVi - 32 ± 8.9 ml / m2, GLS - (-13, 5) ± 4%, GWI - 1192.4 ± 416.2 mm Hg%, GWE - 88.9 ± 6.5%, GCW - 1362.1 ± 442.5 mm Hg%, GWW - 98.5 (69; 130) mm Hg%. The values of the correlation coefficient GWI were: with EF (r = 0.26; p = 0.19), with EDVi (r = -0.3; p = 0.12), with ESVi (r = -0.35; p = 0.07), with GLS (r = 0.85; p = 0.000002). GWE had the following correlation coefficient values: with EF (r = 0.17; p = 0.39), with EDVi (r = -0.42; p = 0.026), with ESVi (r = -0.4; p = 0.025), with GLS (r = 0.74; p = 0.00001). The correlation coefficient of GCW with EF was 0.24 (p = 0.24), with EDVi - (-0.26) (p = 0.19), with ESVi - (- 0.3) (p = 0.1), with GLS - 0.85 (p = 0.000004). The correlation coefficient of GWW with EF was -0.02 (p = 0.9), with EDVi - 0.26 (p = 0.17), with ESVi - 0.2 (p = 0.3), with GLS - 0.37 (p = 0.06). Conclusion the analysis of the correlations between the indicators of myocardial work and the determined parameters revealed that GWE had a moderate correlation with EDVi, ESVi. Parameters GWI, GWE, GCW had a strong correlation with GLS.