Left ventricular remodeling in patients with NSTEMI depending on the risk by the GRACE score

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Objective To identify the features of the structural and functional condition of the myocardium and diastolic transmitral blood flow in patients with NSTEMI depending from GRACE score. Methods 90 patients with NSTEMI were examined. Features of structural and functional condition of the myocardium were determined by echocardiography in M-, B, and D-modes. All of research corresponding to the principles of the Declaration of Helsinki of the World Medical Association. Results Patients were divided into two groups: the first - low and moderate risk, the second - high risk by GRACE score. Thus, it was determined that the patients of the second group in comparison with the first group there was a significant increase in the value of left atrium (40 mm vs. 36 mm, p = 0.03), the index of LA (20.9 mm / m2 vs. 19.2 mm / m2, p = 0.005). Arterial stiffness (AS) was 0.65 mm Hg / ml vs. 0.53 mm Hg / ml (p = 0.02), and aortic diameter index (idA) was 17.3 mm / m2 vs. 17.0 mm / m2 (p = 0.53). The ratio of LA to RA was 1.10 vs. 1.06 (p = 0.04). The Ve / Va ratioin the comparison groups was 0.61 vs. 0.74 (p = 0.02) (Tab. 1). Analysis of structural-geometric remodeling of the left ventricle showed no statistically significant differences in the studied parameters in all comparison groups. In turn, the analysis of the nature of diastolic transmitral blood flow showed significant differences in the type of pseudonormalization in patients with low and moderate risk compared with high risk by GRACE score (9 (16.7%) vs. 14 (38.9%), p = 0.02). Conclusion The main statistical differences between the groups of low and medium risk compared to high according to GRACE score relate mainly to structural parameters.