Abstract
BackgroundEchocardiography is a well-established tool for risk stratification in patients with acute coronary syndrome (ACS). ACS has significant impact on LV dyssynchrony, and detrimental effects on systolic function and long term outcome. The aims of this study were to determine whether LV dyssynchrony carries any predictive information in an unselected ACS population and to evaluate if it has any incremental value to the information given from conventional echocardiographic measurements.MethodsThe study included 227 consecutive ACS patients. Primary endpoint was the composite of death, new MI, or rehospitalisation due to heart failure. Dyssynchrony was measured as intersegmental variation of time to peak strain, the post systolic index (PSI) and myocardial performance index (MPI) with the standard deviation and difference between lowest and highest value (delta) expressing the amount of dyssynchrony. Septal-lateral delay was also tested. All dyssynchrony parameters were compared with Ejection fraction (EF).ResultsThe median follow up time was 53 months. 85 patients reached the combined endpoint. Patients with and without a subsequent combined endpoint differed significantly regarding calculated SD: s and delta-value for PSI, time to peak 2D-strain and MPI but not regarding septal-lateral delay. In ROC-analysis none of the dyssynchrony parameters had larger AUC than EF. When adjusting for traditional risk factors none of the dyssynchrony parameters remained associated with outcome, whereas EF still did.ConclusionLV dyssynchrony seem to have significant prognostic information in patient with acute coronary syndrome but in comparison to conventional parameters such as EF there is no incremental value of this information.
Highlights
Echocardiography is a well-established tool for risk stratification in patients with acute coronary syndrome (ACS)
Echocardiography is a well-established tool for risk stratification and therapy guidance in patients having acute coronary syndrome (ACS), and echocardiographic measurements such as ejection fraction (EF), wall motion score index (WMSI), the ratio of early mitral inflow over myocardial velocity (E/é), myocardial strain and strain-rate reflecting left ventricular (LV) systolic
Whether LV mechanical dyssynchrony have an incremental prognostic value in unselected patients with ACS in addition to traditional measures of systolic function has not been studied to our knowledge
Summary
Echocardiography is a well-established tool for risk stratification in patients with acute coronary syndrome (ACS). ACS has significant impact on LV dyssynchrony, and detrimental effects on systolic function and long term outcome. The aims of this study were to determine whether LV dyssynchrony carries any predictive information in an unselected ACS population and to evaluate if it has any incremental value to the information given from conventional echocardiographic measurements. Echocardiography is a well-established tool for risk stratification and therapy guidance in patients having acute coronary syndrome (ACS), and echocardiographic measurements such as ejection fraction (EF), wall motion score index (WMSI), the ratio of early mitral inflow over myocardial velocity (E/é), myocardial strain and strain-rate reflecting left ventricular (LV) systolic. The aims of this study were to determine whether LV dyssynchrony carries any predictive information in an unselected ACS population and to evaluate if this prognostic information has any incremental value to the information given from conventional and established echocardiographic measurements
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
