Admission Bedside Lung Ultrasound Reclassifies Mortality Prediction in Patients With ST-Segment–Elevation Myocardial Infarction

Araújo, Gustavo Neves de; Silveira, Anderson Donelli da; Scolari, Fernando Luís; Custodio, Julia Luchese; Marques, Felipe; Beltrame, Rafael; Menegazzo, Willian Roberto; Machado, Guilherme Pinheiro; Fuchs, Felipe Costa; Gonçalves, Sandro Cadaval; Wainstein, Rodrigo Vugman; Leiria, Tiago Luiz Luz; Wainstein, Marco Vugman

doi:10.1161/circimaging.119.010269

Cited by 30 publications

(24 citation statements)

References 25 publications

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“…The included studies were conducted between 2010 and 2021 in Argentina, Brazil, China, and Italy and included a total of 1199 patients with ACS. Three studies enrolled patients with STEMI, 10–12 one patients with STEMI or NSTEMI 13 and one patients with STEMI, NSTEMI, or unstable angina 14 . One publication included 112 (51%) of patients that were also included in another analysis by this study group that is included in this review 11,12 .…”

Section: Resultsmentioning

confidence: 99%

“…Three studies enrolled patients with STEMI, 10–12 one patients with STEMI or NSTEMI 13 and one patients with STEMI, NSTEMI, or unstable angina 14 . One publication included 112 (51%) of patients that were also included in another analysis by this study group that is included in this review 11,12 . Therefore, the total number of unduplicated patients in this systematic review is 1087.…”

Section: Resultsmentioning

confidence: 99%

“…Investigators used either phased array or curvilinear transducers for image acquisition. The number of LUS zones investigated was 28 zones in two studies 10,14 and eight zones in the three most recent publications 11–13 . None of the studies reported offline image analysis, that is, without blinding to clinical findings.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence and prognostic importance of lung ultrasound findings in acute coronary syndrome: A systematic review

et al. 2021

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Background Heart failure (HF) complicating acute coronary syndrome (ACS) is a herald of adverse outcomes. In this systematic review, we investigated the prevalence of lung ultrasound (LUS) findings and their prognostic utility among patients with ACS. Methods We searched the online databases PubMed, EMBASE, and Web of Science for studies (full‐text articles, published in English) that used LUS in adult patients with ACS [ST‐elevation myocardial infarction (STEMI), non‐ST‐elevation myocardial infarction (NSTEMI), and unstable angina]. Results Of 462 studies screened, five prospective, observational investigations published between 2010 and 2021 including 1087 patients met our inclusion criteria. Two studies employed 28‐zone imaging protocols whereas three used eight‐zone protocols. The proportion of patients with a prior HF diagnosis was ≤ 5% in all studies. The prevalence of B‐lines was examined prior to or within 12 hours after coronary angiogram and reporting varied between studies due to different imaging protocols or quantification methods. A higher number of B‐lines on admission was associated with an increased risk for developing symptomatic HF during the baseline hospitalization and with a higher in‐hospital mortality rate using either 8 or 28‐zone protocols. A higher number of B‐lines at baseline was also associated with an increased risk of subsequent HF hospitalization or all‐cause death. Conclusions Pulmonary congestion by LUS performed on admission appears to be a common finding among patients hospitalized for ACS and is associated with adverse in‐hospital and long‐term outcomes. Further investigations using standardized LUS protocols are warranted and have the potential to improve risk stratification in ACS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Prevalence and prognostic importance of lung ultrasound findings in acute coronary syndrome: A systematic review

et al. 2021

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“…Araujo et al 24 published a study where the addition of lung ultrasound to Killip classification in patients with an ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention was more sensitive than physical examination to identify patients at high risk of for in-hospital mortality. Our data support and add new information: lung ultrasound may also detect patients at high risk to develop heart failure.…”

Section: Discussionmentioning

confidence: 99%

Lung ultrasound in acute myocardial infarction. Updating Killip & Kimball

Parras¹,

Onocko²,

Traviesa³

et al. 2021

Indian Heart Journal

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Background Heart failure complicating acute myocardial infarction marks an ominous prognosis. Killip and Kimball's classification of heart failure remains a useful tool in these patients. Lung ultrasound can detect pulmonary congestion but its usefulness in this scenario is unknown. Objective To investigate the diagnostic accuracy of lung ultrasound to predict heart failure in patients with acute myocardial infarction. Methods Patients admitted with acute myocardial infarction and without heart failure were evaluated with a lung ultrasound. The presence of B-lines was recorded and counted. The presence of new heart failure (Killip Class B, C, or D) during hospitalization was evaluated by a cardiologist blinded to the results of lung ultrasound. A ROC curve analysis was done to evaluate the diagnostic accuracy of B-lines to predict heart failure. Results 200 patients were included. Three patients were diagnosed with cardiogenic shock, 5 with acute pulmonary edema, and 17 with mild heart failure. Patients who develop heart failure had a median of 14 B-lines, however, patients who remained in Killip class A had a median of 2 ( p = 0,0001). The area under the ROC curve of the sum of B-lines to predict any form of heart failure was 0,91 (CI95% 86–97). The best cut-off value was 5 B-lines, with a sensitivity of 88% (IC95% 68,8–97,5) and specificity of 81% (IC95% 73,9–86,2). Conclusion Lung ultrasound done at admission can help to predict heart failure In patients with acute myocardial infarction.

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“…Acute myocardial infarction is a common cardiovascular disease associated with high mortality rates 1,2 . Timely and effective reperfusion is an important therapeutic option for minimizing myocardial damage following acute myocardial infarction 3,4 .…”

Section: Introductionmentioning

confidence: 99%

lncRNA XIST knockdown suppresses hypoxia/reoxygenation (H/R)‐induced apoptosis of H9C2 cells by regulating miR‐545‐3p/G3BP2

Xiao

Tong

et al. 2021

IUBMB Life

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This study was aimed at determining the roles and functions of lncRNA XIST/miR‐545‐3p/G3BP2 axis during hypoxia/reoxygenation (H/R)‐induced H9C2 cell apoptosis. H9C2 cells were distributed into two groups, the H/R injury and control groups. High‐throughput lncRNA sequencing was applied in the determination of differentially expressed lncRNAs between H/R‐induced H9C2 cells and normal H9C2 cells. Real‐time polymerase chain reactions (RT‐PCR) were used to confirm the expression levels of lncRNA XIST in H/R‐induced H9C2 cells. H9C2 cells were then transfected with lncRNA XIST recombinant plasmid (lncRNA XIST), sh‐LINC XIST, agomiR‐545‐3p, antagomiR‐545‐3p, pcDNA‐G3BP2, sh‐G3BP2, and a corresponding negative control (NC). Bioinformatic analyses revealed that MiR‐545‐3p was a target for lncRNA XIST. This finding was confirmed by dual‐luciferase reporter assay. The degree of cell apoptosis was evaluated by a flow cytometer. RT‐PCR and western blot were performed to assess the apoptotic‐related proteins in each group. A total of 859 differentially expressed lncRNAs (up‐regulated = 502, down‐regulated = 357) were identified. LncRNA XIST was found to be down‐regulated in H/R‐induced H9C2 cells while miR‐545‐3p was distinctly up‐regulated. miR‐545‐3p was established to be a direct target for LncRNA XIST. LncRNA XIST significantly enhanced the apoptotic rate, while its inhibition suppressed the apoptotic rate. AgomiR‐545‐3p partially blocked the lncRNA XIST and enhanced the apoptosis of H/R‐induced H9C2 cells. Moreover, miR‐545‐3p was shown to be a direct target for G3BP2. The overexpression of G3BP2 partially reversed the apoptotic effects of miR‐545‐3p on H/R‐induced H9C2 cells. lncRNA XIST/miR‐545‐3p/GBP2 was found to be an apoptotic regulator in H/R‐induced H9C2 cells.

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Admission Bedside Lung Ultrasound Reclassifies Mortality Prediction in Patients With ST-Segment–Elevation Myocardial Infarction

Cited by 30 publications

References 25 publications

Prevalence and prognostic importance of lung ultrasound findings in acute coronary syndrome: A systematic review

Prevalence and prognostic importance of lung ultrasound findings in acute coronary syndrome: A systematic review

Lung ultrasound in acute myocardial infarction. Updating Killip & Kimball

lncRNA XIST knockdown suppresses hypoxia/reoxygenation (H/R)‐induced apoptosis of H9C2 cells by regulating miR‐545‐3p/G3BP2

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