Abstract
Aim To evaluate the prognostic significance of the left ventricular global function index (LV GFI) in patients with acute coronary syndrome (ACS) using echocardiography (EchoCG).Material and methods The LV GFI is an index that integrates LV cavity volumes, stroke volume, and myocardial volume. This study included 2169 patients with ACS (1340 (61.8%) men) aged 64.1±12.6 years from two observational multicenter studies, ORACLE I and ORACLE II. 1800 (83 %) cases were associated with increased concentrations of myocardial injury markers, including 826 (38.1 %) cases of ST segment elevation myocardial infarction (MI). The observation was started on the 10th day of clinical condition stabilization and lasted for one year. EchoCG was performed with evaluation of LV GFI, which was calculated as a ratio of LV stroke volume to LV global volume. The LV global volume was calculated as a sum of mean LV cavity volume (LV end-diastolic volume + LV end-systolic volume / 2) and LV myocardial volume.Results The main outcome of the study was all-cause death (n=193); recurrent coronary complications (n=253) were analyzed separately. The only EchoCG parameter indicating an adverse outcome during the one-year follow-up was a LV GFI decrease to below 22.6 % with a sensitivity of 72 % and a specificity of 60% (area under the curve, AUC=0.63). A LV GFI <22.6 % was an independent predictor of all-cause death (p=0.019) along with age (p=0.0001), history of MI (p=0.034), and presence of heart failure (HF) (p=0.044), diabetes mellitus (p=0.012), and peripheral atherosclerosis (p=0.001). The LV GFI <22.6 %, (p=0.044), heart rate upon discharge from the hospital (p=0.050), history of MI (p=0.006), presence of HF (p=0.014), and peripheral atherosclerosis (p=0.001) were also independent predictors for recurrent coronary complications. Decreased LV GFI was associated with the risk of fatal outcomes independent of the LV ejection fraction at baseline.Conclusion In patients with ACS, the left ventricular global function index is an independent predictor for all-cause death and recurrent coronary complications and may be used for risk stratification.
Highlights
ФГБОУ ВО «Ставропольский государственный медицинский университет» Минздрава России, Ставрополь, Россия ФГБОУ ВО «Северо-Западный государственный медицинский университет им
Barkhausen J et al Left ventricular global function index assessed by cardiovascular magnetic resonance for the prediction
5. Nwabuo CC, Moreira HT, Vasconcellos HD, Mewton N, Opdahl A, Ogunyankin KO et al Left ventricular global function index predicts incident heart failure and cardiovascular disease in young adults: the coronary artery risk development in young adults (CARDIA) study
Summary
Оценка прогностического значения индекса глобальной функции левого желудочка (ИГФ ЛЖ) у пациентов с острым коронарным синдромом (ОКС) с помощью эхокардиографии (ЭхоКГ). У пациентов с ОКС индекс глобальной функции левого желудочка является независимым предиктором смерти от всех причин и повторных коронарных осложнений и может быть использован для стратификации риска. Индекс глобальной функции левого желудочка в качестве прогностического фактора сердечно-сосудистых осложнений у пациентов с острым коронарным синдромом. Был предложен новый индекс глобальной функции левого желудочка (ИГФ ЛЖ), который определяют на основе результатов магнитно-резонансной томографии (МРТ) сердца [2]. Уже в первых работах было показано, что этот индекс может служить независимым маркером развития разнообразных ССО как у здоровых лиц, так и у пациентов некоторых групп, например, среди больных, перенесших инфаркт миокарда (ИМ) [3, 4]. Цель Оценка прогностического значения ИГФ ЛЖ у пациентов с ОКС с помощью ЭхоКГ. Клиническая характеристика умерших и выживших больных по данным одногодичного наблюдения
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