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Huang CH, Kuo CL, Cheng YS, Huang CS, Liu CS, Chang CC. Sphingolipid Metabolism Is Associated with Cardiac Dyssynchrony in Patients with Acute Myocardial Infarction. Biomedicines 2024; 12:1864. [PMID: 39200328 PMCID: PMC11351212 DOI: 10.3390/biomedicines12081864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 08/10/2024] [Accepted: 08/12/2024] [Indexed: 09/02/2024] Open
Abstract
AIM Sphingolipids are a class of complex and bioactive lipids that are involved in the pathological processes of cardiovascular disease. Fabry disease is an X-linked storage disorder that results in the pathological accumulation of glycosphingolipids in body fluids and the heart. Cardiac dyssynchrony is observed in patients with Fabry disease and left ventricular (LV) hypertrophy. However, little information is available on the relationship between plasma sphingolipid metabolites and LV remodelling after acute myocardial infarction (AMI). The purpose of this study was to assess whether the baseline plasma sphingomyelin/acid ceramidase (aCD) ratio predicts LV dyssynchrony at 6M after AMI. METHODS A total of 62 patients with AMI undergoing primary angioplasty were recruited. Plasma aCD and sphingomyelin were measured prior to primary angioplasty. Three-dimensional echocardiographic measurements of the systolic dyssynchrony index (SDI) were performed at baseline and 6 months of follow-up. The patients were divided into three groups according to the level of aCD and sphingomyelin above or below the median. Group 1 denotes lower aCD and lower sphingomyelin; Group 3 denotes higher aCD and higher sphingomyelin. Group 2 represents different categories of patients with aCD and sphingomyelin. Trend analysis showed a significant increase in the SDI from Group 1 to Group 3. Logistic regression analysis showed that the sphingomyelin/aCD ratio was a significant predictor of a worsening SDI at 6 months. CONCLUSIONS AMI patients with high baseline plasma sphingomyelin/aCD ratios had a significantly increased SDI at six months. The sphingomyelin/aCD ratio can be considered as a surrogate marker of plasma ceramide load or inefficient ceramide metabolism. Plasma sphingolipid pathway metabolism may be a new biomarker for therapeutic intervention to prevent adverse remodelling after MI.
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Affiliation(s)
- Ching-Hui Huang
- Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan;
- Department of Mathematics, National Changhua University of Education, Changhua 500, Taiwan
- Department of Beauty Science and Graduate Institute of Beauty Science Technology, Chienkuo Technology University, Changhua 500, Taiwan
| | - Chen-Ling Kuo
- Vascular Medicine and Diabetes Research Center, Changhua Christian Hospital, Changhua 500, Taiwan; (C.-L.K.); (Y.-S.C.)
| | - Yu-Shan Cheng
- Vascular Medicine and Diabetes Research Center, Changhua Christian Hospital, Changhua 500, Taiwan; (C.-L.K.); (Y.-S.C.)
| | - Ching-San Huang
- Center of Regenerative Medicine and Tissue Repair, Institute of ATP, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Chin-San Liu
- Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Chia-Chu Chang
- Department of Internal Medicine, Kuang Tien General Hospital, Taichung 433, Taiwan
- Department of Nutrition, Hungkuang University, Taichung 433, Taiwan
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van der Bijl P, Delgado V, Bax JJ. Diastolic dyssynchrony by SPECT: A novel parameter to predict post-infarct adverse remodeling. J Nucl Cardiol 2022; 29:1534-1536. [PMID: 33474693 DOI: 10.1007/s12350-020-02484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Pieter van der Bijl
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
| | - Victoria Delgado
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
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3
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Iwahashi N, Kirigaya J, Gohbara M, Abe T, Horii M, Hanajima Y, Toya N, Takahashi H, Kirigaya H, Minamimoto Y, Kimura Y, Okada K, Matsuzawa Y, Hibi K, Kosuge M, Ebina T, Tamura K, Kimura K. Mechanical dispersion combined with global longitudinal strain estimated by three dimensional speckle tracking in patients with ST elevation myocardial infarction. IJC HEART & VASCULATURE 2022; 40:101028. [PMID: 35434256 PMCID: PMC9010606 DOI: 10.1016/j.ijcha.2022.101028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/27/2022] [Accepted: 04/03/2022] [Indexed: 11/13/2022]
Abstract
LV mechanical dispersion is a measure of regional heterogeneity of myocardial contraction. LV mechanical dispersion has been reported as an important prognosticator in STEMI. 3D speckle tracking enables us to precisely measure LV mechanical dispersion. LV mechanical dispersion by 3D speckle tracking can precisely predict prognosis.
Background The role of left ventricular (LV) mechanical dispersion estimated after an ST elevation acute myocardial infarction (STEMI) remains unclear. Methods The study participants were 208 consecutive patients (152 men, age = 72 years) presenting with STEMI for the first time who underwent primary percutaneous coronary intervention (PCI) within 12 h of STEMI onset. Within 48 h of PCI (mean = 24 h), 2D and 3D speckle-tracking echocardiography were performed. The global longitudinal strain (GLS) was calculated using 3D (3D-GLS) and 2D (2D-GLS) speckle tracking. Mechanical dispersion was defined using the standard deviation (SD) of the time to regional peak longitudinal strain (LS) for all 16 segments for both 2D-STE and 3D-STE (2D-LS-SD, 3D-LS-SD). Infarct size was estimated by Tc99m-sestamibi as the total area of < 50% of the uptake area at 2 weeks. The patients were followed up for a longer period of time (median118months) and checked for major adverse cardiac events (MACE: cardiac death, heart failure). Results During follow-up, 55 patients experienced MACE. The cut-off values were determined using receiver operating characteristic curves. The multivariate analysis revealed that a 3D-LS-SD > 56.7 ms was a significant predictor of MACEs (hazard ratio = 1.991, 95% confidence interval 1.033–3.613, p = 0.03), but 2D-LS-SD > 58.1 ms was not an independent predictor of MACEs (hazard ratio = 1.577, 95% confidence interval 0.815–3.042, p = 0.1). Furthermore, the combination of 3D-GLS and 3D-LS-SD had accurate predictability for MACE, as shown by the Kaplan-Meier curves (log rank, χ2 = 94.1, p < 0.0001). Conclusions LV mechanical dispersion besides 3D-GLS assessed by 3D-STE immediately after PCI can predict long-term prognosis.
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Feher A, Pócsi M, Papp F, Szanto TG, Csoti A, Fejes Z, Nagy B, Nemes B, Varga Z. Functional Voltage-Gated Sodium Channels Are Present in the Human B Cell Membrane. Cells 2022; 11:1225. [PMID: 35406789 PMCID: PMC8998058 DOI: 10.3390/cells11071225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 02/04/2023] Open
Abstract
B cells express various ion channels, but the presence of voltage-gated sodium (NaV) channels has not been confirmed in the plasma membrane yet. In this study, we have identified several NaV channels, which are expressed in the human B cell membrane, by electrophysiological and molecular biology methods. The sensitivity of the detected sodium current to tetrodotoxin was between the values published for TTX-sensitive and TTX-insensitive channels, which suggests the co-existence of multiple NaV1 subtypes in the B cell membrane. This was confirmed by RT-qPCR results, which showed high expression of TTX-sensitive channels along with the lower expression of TTX-insensitive NaV1 channels. The biophysical characteristics of the currents also supported the expression of multiple NaV channels. In addition, we investigated the potential functional role of NaV channels by membrane potential measurements. Removal of Na+ from the extracellular solution caused a reversible hyperpolarization, supporting the role of NaV channels in shaping and maintaining the resting membrane potential. As this study was mainly limited to electrophysiological properties, we cannot exclude the possible non-canonical functions of these channels. This work concludes that the presence of voltage-gated sodium channels in the plasma membrane of human B cells should be recognized and accounted for in the future.
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Affiliation(s)
- Adam Feher
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.F.); (F.P.); (T.G.S.); (A.C.)
| | - Marianna Pócsi
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (M.P.); (Z.F.); (B.N.J.)
| | - Ferenc Papp
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.F.); (F.P.); (T.G.S.); (A.C.)
| | - Tibor G. Szanto
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.F.); (F.P.); (T.G.S.); (A.C.)
| | - Agota Csoti
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.F.); (F.P.); (T.G.S.); (A.C.)
| | - Zsolt Fejes
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (M.P.); (Z.F.); (B.N.J.)
| | - Béla Nagy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (M.P.); (Z.F.); (B.N.J.)
| | - Balázs Nemes
- Department of Organ Transplantation, Faculty of Medicine, Institute of Surgery, University of Debrecen, H-4032 Debrecen, Hungary;
| | - Zoltan Varga
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.F.); (F.P.); (T.G.S.); (A.C.)
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Filomena D, Cimino S, Monosilio S, Galea N, Mancuso G, Francone M, Tonti G, Pedrizzetti G, Maestrini V, Fedele F, Agati L. Impact of intraventricular haemodynamic forces misalignment on left ventricular remodelling after myocardial infarction. ESC Heart Fail 2022; 9:496-505. [PMID: 34939359 PMCID: PMC8787983 DOI: 10.1002/ehf2.13719] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 12/28/2022] Open
Abstract
AIMS Altered left ventricular (LV) haemodynamic forces (HDFs) have been associated with positive and negative remodelling after pathogenic or therapeutic events. We aimed to identify LV HDFs patterns associated with adverse LV remodelling (aLVr) in reperfused segment elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS Forty-nine acute STEMI patients underwent cardiac magnetic resonance (CMR) at 1 week (baseline) and after 4 months (follow-up). LV HDFs were computed at baseline from cine CMR long axis data sets, using a novel technique based on endocardial boundary tracking, both in apex-base (A-B) and latero-septal (L-S) directions. HDFs distribution was evaluated by L-S over A-B HDFs ratio (L-S/A-B HDFs ratio %). HDFs parameters were computed over the entire heartbeat, in systole and diastole. At baseline, aLVr patients had lower systolic L-S HDF (2.7 ± 0.9 vs. 3.6 ± 1%; P = 0.027) and higher diastolic L-S/A-B HDF ratio (28 ± 14 vs. 19 ± 6%; P = 0.03). At univariate logistic regression analysis, higher infarct size [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.1; P = 0.04], higher L-S/A-B HDFs ratio (OR 1.1; 95% CI 1.01-1.2; P = 0.05) and lower L-S HDFs (OR 0.41; 95% CI 0.2-0.9; P = 0.04) were associated with aLVr at follow-up. In the multivariable logistic regression analysis, diastolic L-S/A-B HDF ratio remained the only independent predictor of aLVr (OR 1.1; 95% CI 1.01-1.2; P = 0.04). CONCLUSIONS Misalignment of diastolic haemodynamic forces after STEMI is associated with aLVr after 4 months.
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Affiliation(s)
- Domenico Filomena
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences‘Sapienza’ University of RomePoliclinico Umberto I, Viale del Policlinico 155Rome00161Italy
| | - Sara Cimino
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences‘Sapienza’ University of RomePoliclinico Umberto I, Viale del Policlinico 155Rome00161Italy
| | - Sara Monosilio
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences‘Sapienza’ University of RomePoliclinico Umberto I, Viale del Policlinico 155Rome00161Italy
| | - Nicola Galea
- Department of Radiological, Oncological, and Pathological Sciences‘Sapienza’ University of RomeRomeItaly
- Department of Experimental Medicine‘Sapienza’ University of RomeRomeItaly
| | - Giuseppe Mancuso
- Department of Radiological, Oncological, and Pathological Sciences‘Sapienza’ University of RomeRomeItaly
| | - Marco Francone
- Department of Radiological, Oncological, and Pathological Sciences‘Sapienza’ University of RomeRomeItaly
| | - Giovanni Tonti
- Cardiology Division‘G. D'Annunzio’ UniversityChietiItaly
| | - Gianni Pedrizzetti
- Department of Engineering and ArchitectureUniversity of TriesteTriesteItaly
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences‘Sapienza’ University of RomePoliclinico Umberto I, Viale del Policlinico 155Rome00161Italy
| | - Francesco Fedele
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences‘Sapienza’ University of RomePoliclinico Umberto I, Viale del Policlinico 155Rome00161Italy
| | - Luciano Agati
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences‘Sapienza’ University of RomePoliclinico Umberto I, Viale del Policlinico 155Rome00161Italy
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Kanar BG, Tigen MK, Sunbul M, Cincin AA, Gurel E, Sayar N, Kepez A, Sadıc BO. Evaluation of right ventricular dyssynchrony in patients with acute inferior myocardial infarction and its relation with mortality. Echocardiography 2020; 37:1610-1616. [PMID: 32986898 DOI: 10.1111/echo.14865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/22/2020] [Accepted: 08/31/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate right ventricle (RV) dyssynchrony and its relation with mortality using speckle-tracking echocardiography (STE) in patients with acute inferior myocardial infarction (IMI). METHODS One hundred and fifty-eight consecutive patients with acute IMI treated with primary percutaneous coronary intervention, and 44 healthy subjects were included. RV myocardial involvement (RVMI) was defined as an elevation >1 mm in V1 or V4R and/or the presence of a culprit lesion at the proximal portion of the first RV marginal branch after reviewing coronary angiography. Patients were followed for 3 years to determine the cardiovascular mortality. RESULTS Overall, 70 patients with IMI had RVMI. IMI patients had significantly higher RV peak systolic longitudinal strain dyssynchrony (PLSSD) index, lower peak longitudinal systolic strain (PLSS), longer time to PLSS, and time to PLSS differences compared to healthy controls while the patients with RVMI had significantly worse values compared to patients without RVMI and healthy controls. Twenty-seven patients (17.1%) died within 2 years. RVMI was more prevalent in mortality group, and they had significantly higher RV PSSD index, whereas they had lower RV free wall PLSS and longer time to PLSS differences. Receiver operating characteristics (ROC) analysis revealed that a RV PLSSD index > 65 ms predicted mortality with a sensitivity of 88.9% and specificity of 71.8% in IMI patients. CONCLUSIONS Intra- and inter-ventricular dyssynhcrony may develop in patients with acute IMI, especially in those with RV involvement, which might have a negative effect on the prognosis of these patients.
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Affiliation(s)
- Batur Gonenc Kanar
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Mustafa Kursat Tigen
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Murat Sunbul
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ahmet Altug Cincin
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Emre Gurel
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nurten Sayar
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Alper Kepez
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Beste Ozben Sadıc
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Stiermaier T, Backhaus SJ, Lange T, Koschalka A, Navarra JL, Boom P, Lamata P, Kowallick JT, Lotz J, Gutberlet M, de Waha-Thiele S, Desch S, Hasenfuß G, Thiele H, Eitel I, Schuster A. Cardiac Magnetic Resonance Left Ventricular Mechanical Uniformity Alterations for Risk Assessment After Acute Myocardial Infarction. J Am Heart Assoc 2019; 8:e011576. [PMID: 31387432 PMCID: PMC6759895 DOI: 10.1161/jaha.118.011576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Despite limitations as a stand-alone parameter, left ventricular (LV) ejection fraction is the preferred measure of myocardial function and marker for postinfarction risk stratification. LV myocardial uniformity alterations may provide superior prognostic information after acute myocardial infarction, which was the subject of this study. Methods and Results Consecutive patients with acute myocardial infarction (n=1082; median age: 63 years; 75% male) undergoing cardiac magnetic resonance at a median of 3 days after infarction were included in this multicenter observational study. Circumferential and radial uniformity ratio estimates were derived from cardiac magnetic resonance feature tracking as markers of mechanical uniformity alterations (values between 0 and 1 with 1 reflecting perfect uniformity). The clinical end point was the 12-month rate of major adverse cardiac events, consisting of all-cause death, reinfarction, and new congestive heart failure. Patients with major adverse cardiac events (n=73) had significantly impaired circumferential uniformity ratio estimates (0.76 [interquartile range: 0.67-0.86] versus 0.84 [interquartile range: 0.76-0.89]; P<0.001) and radial uniformity ratio estimates (0.69 [interquartile range: 0.60-0.79] versus 0.76 [interquartile range: 0.67-0.83]; P<0.001) compared with patients without events. Although uniformity estimates did not provide independent prognostic information in the overall cohort, a circumferential uniformity ratio estimate below the median of 0.84 emerged as an independent predictor of outcome in postinfarction patients with LV ejection fraction >35% (n=959), even after adjustment for established risk factors (hazard ratio: 1.99; 95% CI, 1.06-3.74; P=0.033 in multivariable Cox regression analysis). In contrast, LV ejection fraction was not associated with adverse events in this subgroup of patients with acute myocardial infarction. Conclusions Cardiac magnetic resonance-derived estimates of mechanical uniformity alterations are novel markers for risk assessment after acute myocardial infarction, and the circumferential uniformity ratio estimate provides independent prognostic information for patients with preserved or only moderately reduced LV ejection fraction.
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Affiliation(s)
- Thomas Stiermaier
- Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) University Heart Center Lübeck University Hospital Schleswig-Holstein Lübeck Germany.,German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck Lübeck Germany
| | - Sören J Backhaus
- Department of Cardiology and Pneumology University Medical Center Göttingen Georg-August University Göttingen Germany.,German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany
| | - Torben Lange
- Department of Cardiology and Pneumology University Medical Center Göttingen Georg-August University Göttingen Germany.,German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany
| | - Alexander Koschalka
- Department of Cardiology and Pneumology University Medical Center Göttingen Georg-August University Göttingen Germany.,German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany
| | - Jenny-Lou Navarra
- Department of Cardiology and Pneumology University Medical Center Göttingen Georg-August University Göttingen Germany.,German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany
| | - Patricia Boom
- Department of Cardiology and Pneumology University Medical Center Göttingen Georg-August University Göttingen Germany.,German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany
| | - Pablo Lamata
- Department of Biomedical Engineering School of Biomedical Engineering and Imaging Sciences King's College of London London United Kingdom
| | - Johannes T Kowallick
- German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany.,Institute for Diagnostic and Interventional Radiology University Medical Center Göttingen Georg-August University Göttingen Germany
| | - Joachim Lotz
- German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany.,Institute for Diagnostic and Interventional Radiology University Medical Center Göttingen Georg-August University Göttingen Germany
| | - Matthias Gutberlet
- Department of Radiology Heart Center Leipzig at University of Leipzig Germany
| | - Suzanne de Waha-Thiele
- Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) University Heart Center Lübeck University Hospital Schleswig-Holstein Lübeck Germany.,German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck Lübeck Germany
| | - Steffen Desch
- Department of Internal Medicine/Cardiology Heart Center Leipzig at University of Leipzig Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology University Medical Center Göttingen Georg-August University Göttingen Germany.,German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany
| | - Holger Thiele
- Department of Internal Medicine/Cardiology Heart Center Leipzig at University of Leipzig Germany
| | - Ingo Eitel
- Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) University Heart Center Lübeck University Hospital Schleswig-Holstein Lübeck Germany.,German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck Lübeck Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology University Medical Center Göttingen Georg-August University Göttingen Germany.,German Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen Germany.,Department of Biomedical Engineering School of Biomedical Engineering and Imaging Sciences King's College of London London United Kingdom.,Department of Cardiology Royal North Shore Hospital The Kolling Institute Northern Clinical School University of Sydney Australia
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Wakabayashi H, Taki J, Inaki A, Hiromasa T, Yamase T, Akatani N, Okuda K, Shibutani T, Shiba K, Kinuya S. Prognostic Value of Early Evaluation of Left Ventricular Dyssynchrony After Myocardial Infarction. Mol Imaging Biol 2018; 21:654-659. [DOI: 10.1007/s11307-018-1279-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Turan B, Daşli T, Erkol A, Erden İ, Başaran Y. Diastolic Dyssynchrony in Acute ST Segment Elevation Myocardial Infarction and Relationship with Functional Recovery of Left Ventricle. J Cardiovasc Ultrasound 2016; 24:208-214. [PMID: 27721951 PMCID: PMC5050309 DOI: 10.4250/jcu.2016.24.3.208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 07/18/2016] [Accepted: 07/26/2016] [Indexed: 12/02/2022] Open
Abstract
Background Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known. Methods Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated. Diastolic delay was calculated from onset of QRS complex to peak of E wave in tissue Doppler image and presented as maximal temporal difference between peak early diastolic velocity of 6 basal segments of LV (TeDiff). Study patients were compared with demographically matched control group. Results Forty eight consecutive patients (55 ± 10 years, 88% male) and 24 controls (56 ± 6 years, 88% male) were included. TeDiff was higher in STEMI than in controls (35.9 ± 19.9 ms vs. 26.3 ± 6.8 ms, p = 0.025). Presence of DD was higher in STEMI than controls (58% vs. 33%, p = 0.046) according to calculated cut-off value (≥ 29 ms). There was no correlation between TeDiff and change in EDVI, ESVI, and LAVI at 6 months, however TeDiff and change in EF at 6 months was positively correlated (r = 0.328, p = 0.023). Patients with baseline DD experienced remodeling less frequently compared to patients without baseline DD (11% vs. 38%, p = 0.040) during follow-up. Conclusion STEMI disrupts diastolic synchronicity of LV. However, DD during acute phase of STEMI is associated with better recovery of LV thereafter. This suggests that DD is associated with peri-infarct stunned myocardium that is salvaged with primary intervention as well as infarct size.
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Affiliation(s)
- Burak Turan
- Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Tolga Daşli
- Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ayhan Erkol
- Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - İsmail Erden
- Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Yelda Başaran
- Cardiology Department, School of Medicine, Marmara University, Istanbul, Turkey
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10
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Lee JH. Left Ventricular Diastolic Dyssynchrony in Post-Myocardial Infarction Patients: Does It Predict Future Left Ventricular Remodeling? J Cardiovasc Ultrasound 2016; 24:193-194. [PMID: 27721946 PMCID: PMC5050304 DOI: 10.4250/jcu.2016.24.3.193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 09/05/2016] [Accepted: 09/06/2016] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ju-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
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11
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Postinfarct Left Ventricular Remodelling: A Prevailing Cause of Heart Failure. Cardiol Res Pract 2016; 2016:2579832. [PMID: 26989555 PMCID: PMC4775793 DOI: 10.1155/2016/2579832] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 01/13/2016] [Accepted: 01/17/2016] [Indexed: 12/11/2022] Open
Abstract
Heart failure is a chronic disease with high morbidity and mortality, which represents a growing challenge in medicine. A major risk factor for heart failure with reduced ejection fraction is a history of myocardial infarction. The expansion of a large infarct scar and subsequent regional ventricular dilatation can cause postinfarct remodelling, leading to significant enlargement of the left ventricular chamber. It has a negative prognostic value, because it precedes the clinical manifestations of heart failure. The characteristics of the infarcted myocardium predicting postinfarct remodelling can be studied with cardiac magnetic resonance and experimental imaging modalities such as diffusion tensor imaging can identify the changes in the architecture of myocardial fibers. This review discusses all the aspects related to postinfarct left ventricular remodelling: definition, pathogenesis, diagnosis, consequences, and available therapies, together with experimental interventions that show promising results against postinfarct remodelling and heart failure.
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Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial. Eur J Nucl Med Mol Imaging 2015; 43:740-8. [PMID: 26666236 DOI: 10.1007/s00259-015-3279-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 12/01/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Few data are available regarding the relation of left ventricular (LV) mechanical dyssynchrony to remodelling after acute myocardial infarction (MI) and stem cell therapy. We evaluated the 1-year time course of both LV mechanical dyssynchrony and remodelling in patients enrolled in the BONAMI trial, a randomized, multicenter controlled trial assessing cell therapy in patients with reperfused MI. METHODS Patients with acute MI and ejection fraction (EF) ≤ 45 % were randomized to cell therapy or to control and underwent thallium single-photon emission computed tomography (SPECT), radionuclide angiography, and echocardiography at baseline, 3 months, and 1 year. Eighty-three patients with a comprehensive 1-year follow-up were included. LV dyssynchrony was assessed by the standard deviation (SD) of the LV phase histogram using radionuclide angiography. Remodelling was defined as a 20 % increase in LV end-systolic volume index (LVESVI) at 1 year. RESULTS At baseline, LVEF, wall motion score index, and perfusion defect size were significantly impaired in the 43 patients (52 %) with LV remodelling (all p < 0.001), without significant increase in LV mechanical dyssynchrony. During follow-up, there was a progressive increase in LV SD (p = 0.01). Baseline independent predictors of LV remodelling were perfusion SPECT defect size (p = 0.001), LVEF (p = 0.01) and a history of hypertension (p = 0.043). Bone marrow cell therapy did not affect the time-course of LV remodelling and dyssynchrony. CONCLUSIONS LV remodelling 1 year after reperfused MI is associated with progressive LV dyssynchrony and is related to baseline infarct size and ejection fraction, without impact of cell therapy on this process.
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Chung ES, Fischer TM, Kueffer F, Anand IS, Bax JJ, Gold MR, Gorman RC, Theres H, Udelson JE, Stancak B, Svendsen JH, Stone GW, Leon A. The Post–Myocardial Infarction Pacing Remodeling Prevention Therapy (PRomPT) Trial: Design and Rationale. J Card Fail 2015; 21:601-7. [DOI: 10.1016/j.cardfail.2015.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 02/02/2015] [Accepted: 03/10/2015] [Indexed: 11/29/2022]
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Clerfond G, Bière L, Mateus V, Grall S, Willoteaux S, Prunier F, Furber A. End-systolic wall stress predicts post-discharge heart failure after acute myocardial infarction. Arch Cardiovasc Dis 2015; 108:310-20. [PMID: 25858536 DOI: 10.1016/j.acvd.2015.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/03/2014] [Accepted: 01/13/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Compensatory mechanisms activated after myocardial infarction include an increase in systolic wall stress (SWS) and activation of the neurohormonal system. Nevertheless, left ventricular ejection fraction (LVEF) and infarct size are the established primary predictors of outcome after ST-segment elevation myocardial infarction. AIMS To assess the relative impact of various cardiac magnetic resonance (CMR) imaging variables, such as infarct size, LVEF and SWS, on pre- and post-discharge heart failure (HF). METHODS CMR was performed in a prospective study involving 169 patients with first ST-segment elevation myocardial infarction. Common CMR findings, such as SWS, were computed. RESULTS Mean SWS was 16.3±5.1×10(3)N·m(-2), and was systematically higher in patients exhibiting either pre- or post-discharge HF (18.9±5.7 and 21.3±7.6×10(3) N·m(-2), respectively). SWS was moderately related to initial infarct size (r=0.405; P <0.001). In total, 28 patients presented with HF during the hospitalization phase and 14 during follow-up, with a median time of event of 93 days (25th-75th percentiles, 29-139.25 days). The univariate predictors of HF were age, LVEF, infarct size, SWS, microvascular obstruction, anterior infarction and heart rate at admission. Multivariable analysis revealed infarct size and age to be the predictors of predischarge HF, while SWS and heart rate at admission predicted post-discharge HF. The greatest SWS quartile provided a negative predictive value of 95.9%. CONCLUSION Regardless of LVEF and infarct size, SWS was shown to be an independent predictor of post-discharge HF after ST-segment elevation myocardial infarction.
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Affiliation(s)
- Guillaume Clerfond
- L'UNAM université, Angers, France; UPRES 3860, service de cardiologie, laboratoire cardioprotection, remodelage et thrombose, CHU d'Angers, université d'Angers, 49045 Angers cedex 1, France
| | - Loïc Bière
- L'UNAM université, Angers, France; UPRES 3860, service de cardiologie, laboratoire cardioprotection, remodelage et thrombose, CHU d'Angers, université d'Angers, 49045 Angers cedex 1, France.
| | - Victor Mateus
- L'UNAM université, Angers, France; UPRES 3860, service de cardiologie, laboratoire cardioprotection, remodelage et thrombose, CHU d'Angers, université d'Angers, 49045 Angers cedex 1, France
| | - Sylvain Grall
- L'UNAM université, Angers, France; UPRES 3860, service de cardiologie, laboratoire cardioprotection, remodelage et thrombose, CHU d'Angers, université d'Angers, 49045 Angers cedex 1, France
| | - Serge Willoteaux
- L'UNAM université, Angers, France; Service de radiologie, CHU d'Angers, université d'Angers, 49933 Angers cedex 1, France
| | - Fabrice Prunier
- L'UNAM université, Angers, France; UPRES 3860, service de cardiologie, laboratoire cardioprotection, remodelage et thrombose, CHU d'Angers, université d'Angers, 49045 Angers cedex 1, France
| | - Alain Furber
- L'UNAM université, Angers, France; UPRES 3860, service de cardiologie, laboratoire cardioprotection, remodelage et thrombose, CHU d'Angers, université d'Angers, 49045 Angers cedex 1, France
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Huang CH, Chang CC, Kuo CL, Huang CS, Lin CS, Liu CS. Decrease in plasma cyclophilin A concentration at 1 month after myocardial infarction predicts better left ventricular performance and synchronicity at 6 months: a pilot study in patients with ST elevation myocardial infarction. Int J Biol Sci 2015; 11:38-47. [PMID: 25552928 PMCID: PMC4278253 DOI: 10.7150/ijbs.10271] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/05/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Cyclophilin A (CyPA) concentration increases in acute coronary syndrome. In an animal model of acute myocardial infarction, administration of angiotensin-converting-enzyme inhibitor was associated with lower left ventricular (LV) CyPA concentration and improved LV performance. This study investigated the relationships between changes in plasma CyPA concentrations and LV remodeling in patients with ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS We enrolled 55 patients who underwent percutaneous coronary intervention for acute STEMI. Plasma CyPA, matrix metalloproteinase (MMP), interleukin-6 and high-sensitivity C-reactive protein concentrations were measured at baseline and at one-month follow-up. Echocardiography was performed at baseline and at one-, three-, and six-month follow-up. Patients with a decrease in baseline CyPA concentration at one-month follow-up (n = 28) had a significant increase in LV ejection fraction (LVEF) (from 60.2 ± 11.5% to 64.6 ± 9.9%, p < 0. 001) and preserved LV synchrony at six months. Patients without a decrease in CyPA concentration at one month (n = 27) did not show improvement in LVEF and had a significantly increased systolic dyssynchrony index (SDI) (from 1.170 ± 0.510% to 1.637 ± 1.299%, p = 0.042) at six months. Multiple linear regression analysis showed a significant association between one-month CyPA concentration and six-month LVEF. The one-month MMP-2 concentration was positively correlated with one-month CyPA concentration and LV SDI. Conclusions : Decreased CyPA concentration at one-month follow-up after STEMI was associated with better LVEF and SDI at six months. Changes in CyPA, therefore, may be a prognosticator of patient outcome.
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Affiliation(s)
- Ching-Hui Huang
- 1. Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan ; 2. Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan
| | - Chia-Chu Chang
- 3. Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan ; 4. School of Medicine, Chung Shan Medical University, Taichung 404, Taiwan
| | - Chen-Ling Kuo
- 5. Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Ching-Shan Huang
- 5. Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Chih-Sheng Lin
- 2. Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan
| | - Chin-San Liu
- 5. Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua 500, Taiwan ; 6. Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan ; 7. Graduate Institute of Integrative Medicine, China Medical University, Taichung 404, Taiwan
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Yan GH, Wang M, Yue WS, Yiu KH, Siu CW, Lee SW, Lau CP, Tse HF. Elevated pulmonary artery systolic pressure in patients with coronary artery disease and left ventricular dyssynchrony. Eur J Heart Fail 2014; 12:1067-75. [DOI: 10.1093/eurjhf/hfq125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Guo-Hui Yan
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
| | - Mei Wang
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
| | - Wen-Sheng Yue
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
| | - Kai-Hang Yiu
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
| | - Chung-Wah Siu
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
- Research Centre of Heart, Brain, Hormone and Healthy Aging; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Hong Kong Hong Kong
| | - Stephen W.L. Lee
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
| | - Chu-Pak Lau
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
| | - Hung-Fat Tse
- Cardiology Division, Department of Medicine; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital; Hong Kong Hong Kong
- Research Centre of Heart, Brain, Hormone and Healthy Aging; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Hong Kong Hong Kong
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Abd-Elmoniem KZ, Tomas MS, Sasano T, Soleimanifard S, Vonken EJP, Youssef A, Agarwal H, Dimaano VL, Calkins H, Stuber M, Prince JL, Abraham TP, Abraham MR. Assessment of distribution and evolution of mechanical dyssynchrony in a porcine model of myocardial infarction by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2012; 14:1. [PMID: 22226320 PMCID: PMC3268109 DOI: 10.1186/1532-429x-14-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 01/06/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We sought to investigate the relationship between infarct and dyssynchrony post- myocardial infarct (MI), in a porcine model. Mechanical dyssynchrony post-MI is associated with left ventricular (LV) remodeling and increased mortality. METHODS Cine, gadolinium-contrast, and tagged cardiovascular magnetic resonance (CMR) were performed pre-MI, 9 ± 2 days (early post-MI), and 33 ± 10 days (late post-MI) post-MI in 6 pigs to characterize cardiac morphology, location and extent of MI, and regional mechanics. LV mechanics were assessed by circumferential strain (eC). Electro-anatomic mapping (EAM) was performed within 24 hrs of CMR and prior to sacrifice. RESULTS Mean infarct size was 21 ± 4% of LV volume with evidence of post-MI remodeling. Global eC significantly decreased post MI (-27 ± 1.6% vs. -18 ± 2.5% (early) and -17 ± 2.7% (late), p < 0.0001) with no significant change in peri-MI and MI segments between early and late time-points. Time to peak strain (TTP) was significantly longer in MI, compared to normal and peri-MI segments, both early (440 ± 40 ms vs. 329 ± 40 ms and 332 ± 36 ms, respectively; p = 0.0002) and late post-MI (442 ± 63 ms vs. 321 ± 40 ms and 355 ± 61 ms, respectively; p = 0.012). The standard deviation of TTP in 16 segments (SD16) significantly increased post-MI: 28 ± 7 ms to 50 ± 10 ms (early, p = 0.012) to 54 ± 19 ms (late, p = 0.004), with no change between early and late post-MI time-points (p = 0.56). TTP was not related to reduction of segmental contractility. EAM revealed late electrical activation and greatly diminished conduction velocity in the infarct (5.7 ± 2.4 cm/s), when compared to peri-infarct (18.7 ± 10.3 cm/s) and remote myocardium (39 ± 20.5 cm/s). CONCLUSIONS Mechanical dyssynchrony occurs early after MI and is the result of delayed electrical and mechanical activation in the infarct.
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Affiliation(s)
- Khaled Z Abd-Elmoniem
- Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA
| | - Miguel Santaularia Tomas
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Division of Cardiology, Hospital Español de Mexico, Distrito Federal, Mexico
| | - Tetsuo Sasano
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Sahar Soleimanifard
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Evert-Jan P Vonken
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Amr Youssef
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Harsh Agarwal
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Veronica L Dimaano
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Hugh Calkins
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Matthias Stuber
- Department of Radiology, Division of Magnetic Resonance Research, Johns Hopkins University, Baltimore, MD, USA
| | - Jerry L Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Theodore P Abraham
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - M Roselle Abraham
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
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Antoni ML, Boden H, Hoogslag GE, Ewe SH, Auger D, Holman ER, van der Wall EE, Schalij MJ, Bax JJ, Delgado V. Prevalence of dyssynchrony and relation with long-term outcome in patients after acute myocardial infarction. Am J Cardiol 2011; 108:1689-96. [PMID: 21906706 DOI: 10.1016/j.amjcard.2011.07.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 07/25/2011] [Accepted: 07/25/2011] [Indexed: 10/17/2022]
Abstract
The impact of left ventricular (LV) dyssynchrony on the long-term outcomes of patients with acute myocardial infarction (AMI) remains unknown. The purpose of the present study was to evaluate the prevalence of LV dyssynchrony after AMI and the potential relation with adverse events. A total of 976 consecutive patients admitted with AMI treated with primary percutaneous coronary intervention were evaluated. Two-dimensional echocardiography was performed <48 hours after admission. LV dyssynchrony was assessed with speckle-tracking imaging and calculated as the time difference between the earliest and latest activated segments. Patients were followed up for the occurrence of all-cause mortality (the primary end point) or the composite secondary end point (heart failure hospitalization and all-cause mortality). Within 48 hours of admission for the index infarction, mean LV dyssynchrony was 61 ± 79 ms, and 14% of the patients demonstrated a ≥130-ms time difference, defined as significant LV dyssynchrony. During a mean follow-up period of 40 ± 17 months, 82 patients (8%) reached the primary end point. In addition, 36 patients (4%) were hospitalized for heart failure. The presence of LV dyssynchrony was associated with an increased risk for all-cause mortality and hospitalization for heart failure during long-term follow-up (adjusted hazard ratio 1.06, 95% confidence interval 1.05 to 1.08, p <0.001, per 10-ms increase). Moreover, LV dyssynchrony provided incremental value over known clinical and echocardiographic risk factors for the prediction of adverse outcomes. In conclusion, LV dyssynchrony is a strong predictor of long-term mortality and hospitalization for heart failure in a population of patients admitted with ST-segment elevation AMI treated with primary percutaneous coronary intervention.
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Turan B, Yilmaz F, Karaahmet T, Tigen K, Mutlu B, Basaran Y. Role of Left Ventricular Dyssynchrony in Predicting Remodeling after ST Elevation Myocardial Infarction. Echocardiography 2011; 29:165-72. [DOI: 10.1111/j.1540-8175.2011.01574.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kitagawa K, Choi BW, Chan C, Jinzaki M, Tsai IC, Yong HS, Yu W. ASCI 2010 appropriateness criteria for cardiac magnetic resonance imaging: a report of the Asian Society of Cardiovascular Imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group. Int J Cardiovasc Imaging 2010; 26:173-86. [PMID: 20734234 PMCID: PMC3252886 DOI: 10.1007/s10554-010-9687-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 08/11/2010] [Indexed: 01/16/2023]
Abstract
There has been a growing need for standard Asian population guidelines for cardiac CT and cardiac MR due to differences in culture, healthcare system, ethnicity and disease prevalence. The Asian Society of Cardiovascular Imaging, as the only society dedicated to cardiovascular imaging in Asia, formed a cardiac CT and cardiac MR guideline working group in order to help Asian practitioners to establish cardiac CT and cardiac MR services. In this ASCI cardiac MR appropriateness criteria report, 23 Technical Panel members representing various Asian countries were invited to rate 50 indications that can frequently be encountered in clinical practice in Asia. Indications were rated on a scale of 1–9 to be categorized into ‘appropriate’ (7–9), ‘uncertain’ (4–6), or ‘inappropriate’ (1–3). According to median scores of the 23 members, the final ratings for indications were 24 appropriate, 18 uncertain and 8 inappropriate with 22 ‘highly-agreed’ (19 appropriate and 3 inappropriate) indications. This report is expected to have a significant impact on the cardiac MR practices in many Asian countries by promoting the appropriate use of cardiac MR.
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Maruyama Y, Masaki N, Yoshimoto N. Dyssynchrony during acute phase determined by real-time three-dimensional echocardiography predicts reverse cardiac remodeling and improved cardiac function after reperfusion therapy. J Cardiol 2009; 54:432-40. [DOI: 10.1016/j.jjcc.2009.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 07/15/2009] [Accepted: 07/16/2009] [Indexed: 11/16/2022]
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Maruyama Y, Masaki N, Shimizu Y, Honda N, Yoshimoto N. Correlation of left ventricular dyssynchrony with myocardial stunning using dual single photon emission computed tomography of 123iodine-β-methyl iodophenyl pentadecanoic acid and 201thallium scintigraphy after reperfusion therapy. Ann Nucl Med 2009; 23:799-805. [DOI: 10.1007/s12149-009-0312-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 09/25/2009] [Indexed: 10/20/2022]
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