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Toader DM, Magareata G, Craciun-Mirescu A, Tiereanu E, Trasca P, Stavaru R, Militaru C, Rocsoreanu A, Cojocaru A, Belu A, Preda G, Cirstea I, Aniculesei A, Mandia R, Nita D. Layer specific strain analysis and QTc interval in patients with STEMI and TIMI 3 early after percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart rate-corrected (QTc) interval may increase in the setting of ST-elevation myocardial infarction (STEMI) even after complete reperfusion of the infarct-related artery. The remaining ischemia affects ventricular repolarization and may be associated with an increased susceptibility for malignant ventricular arrhythmias. Two-dimensional (2D) speckle tracking echocardiography (STE) is an angle-independent technique for evaluating myocardial function. The study aimed to analyze the layers specific strain using STE in patients after percutaneous coronary intervention (PCI) and find a possible correlation with QTc interval.
Methods
74 patients with STEMI and TIMI 3 flow after PCI were enrolled. The study did not include patients with bundle branch block, pacing, or treated with drugs that could increase the QTc interval. The evaluation consisted of clinical examination and laboratory tests. 12 leads electrocardiography evaluated QTc interval. Echocardiographic acquisitions were performed in the first 24–48 hours after PCI, and data were analyzed on the workstation. The global longitudinal strain was measured from apical views, at the level of the endocardium GLSAvgEndo, transmural GLSAvg, epicardium GLSAvgEpi; the difference bewtwen endocardium and epicardium longitudinal strain: GLSAvgEndo-GLSAvgEpi. Layer-specific GLS values were measured as the average of the longitudinal strain of 17 LV segments at each individual layer (Figure 1).
Results
Patients were diveded in two groups: the first included 32 patients with a single vessel disease (43.24%) and the second, 42 patients (56.75%) with multiple vessel damage, but without other indication for revascularization except the culprit lesion. Values for layers strain and QTc interval in the first group were: GLSAvgEndo: −16.2 (SD 2.98, CV 0.18), GLSAvg: −11.46 (SD 6.98, CV 0.6), GLSAvgEndo-GLSAvgEpi: 3.54 (DS 1.06, CV 0.29), QTc: 452.5 (SD 22.65, CV 0.05) and in the second group: GLSAvgEndo: −13.22 (SD 4.01, CV 0.3), GLSAvg: −11.3 (SD 3.39, CV 0.29), GLSAvgEndo-GLSAvgEpi: 3.47 (CV 1.28, CV 0.37), QTc: 490ms (SD 43.07, CV 0.08). QTc interval correlated with and layers strain in the first group: GLSAvgEndo: r=0.56, GLSAvg: r=0.67, GLSendo-GLSepi: r=0.54, and in the second group: GLSAvgEndo: r=0.73, GLSAvg: r=0.75, GLSAvgEndo-GLSAvgEpi: r=0.62.
Conclusions
1. The present study identified decreased longitudinal strain in all myocardial layers in the first days after STEMI, even after a successful PCI. 2. Alterations of QTc dynamicity were more frequent in patients with multivessel lesions 3. The electrical instability related by QTc interval correlated with the myocardial tissue damage related by STE. The correlation was more evident in patients with multivessel disease, even with remaining nonsignificant lesions, suggesting an ongoing process of microcirculatory perfusion damage.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | | | - E Tiereanu
- University of Medicine and Pharmacy of Craiova , Craiova , Romania
| | - P Trasca
- Cardiology Center , Craiova , Romania
| | - R Stavaru
- Cardiology Center , Craiova , Romania
| | - C Militaru
- University of Medicine and Pharmacy of Craiova , Craiova , Romania
| | - A Rocsoreanu
- University of Medicine and Pharmacy of Craiova , Craiova , Romania
| | - A Cojocaru
- University of Medicine and Pharmacy of Craiova , Craiova , Romania
| | - A Belu
- Cardiology Center , Craiova , Romania
| | - G Preda
- Cardiology Center , Craiova , Romania
| | - I Cirstea
- Cardiology Center , Craiova , Romania
| | | | - R Mandia
- Cardiology Center , Craiova , Romania
| | - D Nita
- Cardiology Center , Craiova , Romania
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Dragomirescu M, Vintila T, Preda G, Luca A, Croitoru V. Cellulases and Amylases Entrapped in Sol-Gel Derived Silica Matrixes. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.09.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dragomirescu M, Vintila T, Preda G. Activity and stability of starch converting enzymes entrapped in silica gels. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cattaneo V, Preda G, Corvi G, Bonichi OF. [Apicectomy: indications and technic]. Riv Ital Stomatol 1978; 47:21-6. [PMID: 287167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Cattaneo V, Gremmo E, Preda G, Resta G. [Root canal therapy with sodium dioxide]. Riv Ital Stomatol 1978; 47:13-9. [PMID: 287166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Cattaneo V, Gremmo E, Preda G. [Preliminary treatment of root canal]. Riv Ital Stomatol 1978; 47:5-12. [PMID: 287169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Cattaneo V, Brusotti C, Preda G, Spondrini G, Pinelli G. [Applications of the ETCH technic and orthodontic brackets in some clinical cases]. Minerva Stomatol 1976; 25:159-63. [PMID: 1070571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The Authors shawed how the sealants having a resin base that can establish with tooth surfaces treated with acid, a sound connection among these and orthodontic brackets, originally used in orthodontic treatment, can also be used for fixation of fractures. The case described concern seven patients with a fracture of maxillaries. It was demonstrated that such a procedure was easy to execute for the operator and did not give any trouble to the patient. The results obtained were satisfactory.
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Preda G. [Dentistry for the handicapped]. Minerva Stomatol 1976; 25:95-102. [PMID: 137357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The treatment of the handicapped is discussed in the light of the alterations by which they are most commonly afflicted. The relationship between such subjects and dentists is examined. The results of personal experience are presented. It is suggested that a greater degree of attention should be given to this question by the health authorities.
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