Left ventricular myocardial work in the culprit vessel territory and impact on left ventricular remodelling in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Lustosa, Rodolfo de Paula; Fortuni, Federico; Bijl, Pieter van der; Goedemans, Laurien; Mahdiui, Mohammed El; Montero-Cabezas, José M.; Kostyukevich, Marina V.; Marsan, Nina Ajmone; Bax, Jeroen J.; Delgado, Victoria; Knuuti, Juhani

doi:10.1093/ehjci/jeaa175

Cited by 31 publications

(21 citation statements)

References 29 publications

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“…This is concordant with Khurelsukh et al (24) who found non-significant difference between the study group regarding culprit MI territory whether anterior or non-anterior STEMI. On the contrary this was discordant with Lustosa et al (25) who found that, the regional values of MWI and MWE in the culprit vessel territory of LAD and LCx were significantly lower in patients with early LV remodeling compared to patients without early LV remodeling. These discrepancies with our study might be explained by the small sample size of our study design.…”

Section: Discussionsupporting

confidence: 57%

Predictors of Contractile Recovery After Successful Primary Percutaneous Coronary Intervention

Awady¹,

Roshdy²,

Mohammad³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Accurate diagnosis, characterization, and quantification of myocardial infarction (MI) are essential to assess the impact of therapy and to aid in predicting prognosis of patients with ischaemic heart disease.Objective: This study aimed to define different parameters regarding prediction of myocardial functional recovery following successful reperfusion of acute ST segment elevation myocardial infarction (STEMI). Patients and methods: This prospective study was carried out in Zagazig University and National Heart Institute (NHI) of Egypt during the period from June 2020 to June 2021. The study included 48 patients admitted with first acute STEMI. All patients were subjected to demographic data taking, electrocardiography and echocardiography examination (two examinations were done, the first was immediately after reperfusion and the second was 3 months from primary percutaneous coronary intervention (PCI). Results: There was no statistically significant difference between demographic data and risk factors except smoking habit. Regarding laboratory findings there were significant lower troponin value, peak CKMB value compared to patients had remolding (p=0.0001, p=0.027 respectively). Regarding ECG parameters, there was no statistical significant difference between the study groups regarding sum ST elevation and MI territory (p value > 0.05), but there was highly statistically significant difference between the study groups regarding 90 min ST resolution among contractile recovery (group I) p=0.0001. Conclusions: In this study patients affected by AMI with ST segment elevation and treated by primary PCI showed contractile recovery in 60.4% of the patients, while the remodeling of the LV has been observed in 39.6%.

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Section: Discussionsupporting

confidence: 57%

Predictors of Contractile Recovery After Successful Primary Percutaneous Coronary Intervention

Awady¹,

Roshdy²,

Mohammad³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…In our cohort, the MWI and MCW increased significantly after intervention. Recent studies have demonstrated in patients with anterior ST-elevation myocardial infarction who received PCI that MW is an independent predictor of LV recovery and early adverse LV remodeling ( 40 , 41 ). MW may be a useful tool to monitor the myocardial function during the short- and long-term follow-up of patients after PCI.…”

Section: Discussionmentioning

confidence: 99%

Regional Myocardial Work Measured by Echocardiography for the Detection of Myocardial Ischemic Segments: A Comparative Study With Invasive Fractional Flow Reserve

Guo

Yang

Wang

et al. 2022

Front. Cardiovasc. Med.

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PurposeThis study is to assess the diagnostic value of noninvasive regional myocardial work (MW) by echocardiography for detecting the functional status of coronary stenosis using fractional flow reserve (FFR) as a standard criterion.MethodsA total of 84 consecutive patients were included in this study, among which 92 vessels were identified with ≥50% stenosis confirmed by invasive coronary angiography. Patients were investigated by invasive FFR and transthoracic echocardiography. Regional MW indices including myocardial work index (MWI), myocardial constructive work (MCW), myocardial wasted work, and myocardial work efficiency were calculated.ResultsMWI and MCW were significantly impaired in the FFR ≤ 0.75 group compared with the FFR > 0.75 group (both p < 0.01). There were significant positive associations between MWI and MCW with FFR. In total group, MWI <1,623.7 mmHg% [sensitivity, 78.4%; specificity, 72.2%; area under the curve value, 0.768 (0.653–0.883)] and MCW <1,962.4 mmHg% [77.0%; 72.2%; 0.767 (0.661–0.872)], and in single-vessel subgroup, MWI <1,412.1 mmHg% [93.5%; 63.6%; 0.808 (0.652–0.965)] and MCW <1,943.3 mmHg% [(84.8%; 72.7%; 0.800 (0.657–0.943)] were optimal to detect left ventricular segments with an FFR ≤ 0.75. MWI and MCW significantly increased after percutaneous coronary intervention in 13 cases.ConclusionIn patients with coronary artery disease, especially those with single-vessel stenosis, the regional MW measured by echocardiography exhibited a good diagnostic value in detecting significant myocardial ischemia compared to the standard FFR approach.

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“…Meimoun et al demonstrated that constructive work was the best parameter to predict segmental and global LV recovery after anterior ST elevation myocardial infarction (STEMI) and that patients with in-hospital complications had more severely impaired GCW (p < 0.01) [45]. In STEMI patients treated with percutaneous coronary intervention (PCI), lower values of global and segmental work index in the territory of the culprit lesion were associated with early remodeling of the LV [46]. Finally, MW has been applied in stress echocardiography examinations revealing statistically significant segmental decrease of work index in cases of inducible ischemia and inability of GWI increase, which was in contrast to healthy subjects where GWI increased by 54% [47].…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Myocardial Work: Methodology and Clinical Applications

et al. 2021

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A precise and accurate assessment of left ventricular (LV) contractility is of utmost importance in terms of prognosis in most cardiac pathologies. Given the limitations of ejection fraction (EF) and global longitudinal strain (GLS) due to their load dependency, a novel imaging tool called myocardial work (MW) has emerged as a promising method for LV performance evaluation. MW is a novel, less load-dependent method based on computation of myocardial strain–arterial blood pressure curves. This method provides a more detailed assessment of segmental and global LV function incorporating the patient’s LV pressure and is derived by brachial artery pressure utilizing an empiric reference curve adjusted to the duration of the isovolumic and ejection phases as determined by echocardiography. The clinical implications of this unique method have been expanding in the last few years, which attest to the robust additive role of MW in routine practice.

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Left ventricular myocardial work in the culprit vessel territory and impact on left ventricular remodelling in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Cited by 31 publications

References 29 publications

Predictors of Contractile Recovery After Successful Primary Percutaneous Coronary Intervention

Predictors of Contractile Recovery After Successful Primary Percutaneous Coronary Intervention

Regional Myocardial Work Measured by Echocardiography for the Detection of Myocardial Ischemic Segments: A Comparative Study With Invasive Fractional Flow Reserve

Myocardial Work: Methodology and Clinical Applications

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