The long-term prognostic value of E/e’ in patients with ST segment elevation myocardial infarction

Park, Jino; Song, Yeo-Jeong; Kim, Seunghwan; Kim, Dong-Kie; Kim, Ki‐Hun; Seol, Sang–Hoon; Kim, Doo-Il; Ha, Sang Jin

doi:10.1016/j.ihj.2022.08.002

Cited by 2 publications

(3 citation statements)

References 29 publications

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“…Consistent with our result, Gong et al [17] showed statistically significant difference between MACE and no MACE groups as regards mean LVEF (46.1 ± 6.9% vs. 52.3 ± 9.0% with p value= 0.009) and mean LVESV, which was higher in MACE group (76.1±15.6 ml vs. 61.9±18.2 ml with p-value= 0.002). Also, Park et al [18] evaluated the long-term prognostic significance of E/e' in STEMI patients and found that those with an aberrant E/e' ratio (>15) had a considerably larger percentage of MACEs than those with a normal E/e' ratio (34.8% vs. 12.7%, p 0.001). Patients in that study were subdivided according to E/e' ratio into two groups (E/e' > 15 and E/e' < 15) and showed statistically significant higher mean E wave velocity (87.37 ± 25.88 cm/s vs. 62.65 ± 16.57 cm/s, with p value < 0.001) and lower mean septal e' wave velocity (4.21 ± 0.17 cm/s vs. 6.43 ± 0.12 cm/s, with p-value < 0.001) in patients with E/e' > 15.…”

Section: Discussionmentioning

confidence: 99%

Role of Systolic Blood Pressure to Left Ventricular End-Diastolic Pressure Ratio in Prediction of Major Adverse Cardiovascular Events in Patients with ST-segment Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

2023

The Egyptian Journal of Hospital Medicine

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Background: Among all cardiovascular illnesses, myocardial infraction is regarded as one of the major causes of morbidity and death. Though, mortality rates have been reduced all over the past few years, there is still a relative risk for occurrence of the different major adverse cardiac events (MACEs). Objective: To evaluate the role of ratio of systolic blood pressure to left ventricular end-diastolic pressure at the time of primary percutaneous coronary intervention (PPCI) to predict MACEs both in-hospital and during 3-months follow up in patients with STEMI. Patients and Methods: This was a multicenter prospective study, conducted in Nasr City Health Insurance Hospital and Benha University Hospital in the period from March 2022 to March 2023. Included 100 patients who were presented by acute STEMI and managed by successful PPCI for a single vessel disease. Results: In our results, there was no statistically significant difference between the 2 groups as regarding demographic data and risk factors. Patients with MACEs had higher incidence of door to balloon time > 90 minutes, higher incidence of Killip class II and III, and of anterior STEMI in comparison with those without MACEs. Also, patients with MACEs had lower SBP and DBP, higher HR, lower LVEF, higher LVESV, higher incidence of DD grade II and lower both mean septal and lateral e' wave velocities, higher mean E wave velocity, both septal and lateral e/e' ratios. Patients with MACEs also had higher TIMI and GRACE RS, LVEDP, higher incidence of LAD as a culprit vessel. While, they had lower invasive SBP, DBP and SBP/LVEDP ratio. Regarding ROC curve analysis, SBP/LVEDP ratio cutoff value of ≤ 4.7 was shown to have the best diagnostic accuracy. TIMI risk score cut-off value > 3 was shown to have the second diagnostic accuracy in prediction of MACEs. AUC of SBP/LVEDP ratio was higher than that of TIMI RS, so SBP/LVEDP ratio was more accurate in predicting MACEs in STEMI patients who underwent primary PCI to a single vessel disease. Conclusion: SBP/LVEDP ratio is an easily rapidly determined ratio at the time of PPCI that can provide important prognostic information regarding risk stratification of STEMI patients.

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Section: Discussionmentioning

confidence: 99%

Role of Systolic Blood Pressure to Left Ventricular End-Diastolic Pressure Ratio in Prediction of Major Adverse Cardiovascular Events in Patients with ST-segment Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

2023

The Egyptian Journal of Hospital Medicine

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“…However, limited data exists on the predictive value of follow‐up GLS and other strain parameters such as GCS. Furthermore, diastolic dysfunction assessed by E/e’ ratio obtained from tissue Doppler imaging (TDI) has been shown to predict LV remodeling after STEMI 17,18 …”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, diastolic dysfunction assessed by E/e' ratio obtained from tissue Doppler imaging (TDI) has been shown to predict LV remodeling after STEMI. 17,18 The objective of this study was to identify convenient reproducible echocardiographic predictors of LVEF recovery in patients with STEMI undergoing PPCI, with a focus on strain parameters, as well as assessing the importance of early follow-up echo assessment, to help identify high-risk patients for adverse LV remodeling who can benefit from intensified post-infarction therapy.…”

Section: Introductionmentioning

confidence: 99%

Incremental prognostic value of speckle tracking echocardiography and early follow‐up echo assessment in predicting left ventricular recovery after reperfusion for ST‐segment elevation myocardial infarction (STEMI)

Yehia,

Zaki,

Sadaka

et al. 2023

Echocardiography

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PurposeUp to 50% of patients do not achieve significant left ventricular ejection fraction (LVEF) recovery after primary percutaneous intervention (PPCI) for STEMI. We aimed to identify the echocardiographic predictors for LVEF recovery and assess the value of early follow‐up echocardiography (Echo) in risk assessment of post‐myocardial infarction (MI) patients.MethodsOne hundred one STEMI patients undergoing PPCI were enrolled provided EF below 50%. Baseline echocardiography assessed LVEF, volumes, wall motion score index (WMSI), global longitudinal strain (GLS), global circumferential strain (GCS), and E/e’. Follow‐up echocardiography after 6 weeks reassessed left ventricular volumes, LVEF and GLS.GCS was not assessed at follow up. Patients were classified into recovery and non‐recovery groups. Predictors of LVEF recovery and major adverse cardiovascular events (MACE) at 6 months were analysed.ResultsThe mean change of EF was 8.04 ± 3.32% in group I versus ‐.39 ± 5.09 % in group II (p < .001). Recovered patients had better baseline GLS, baseline GCS, E/e’, and follow‐up GLS. Multivariate regression analysis revealed E/e’, GCS, and follow‐up GLS after 6 weeks to be strong independent predictors for LVEF recovery. Composite MACE was considerably higher in group II (32.7% vs. 4.1%, p < .001) mainly driven by higher heart failure hospitalisation Multivariate regression analysis revealed baseline GLS, E/e’, and ejection fraction (EF) percentage recovery as strong independent predictors for MACE.ConclusionsMultiparametric echocardiographic approach incorporating LVEF, strain parameters, and diastolic function could allow early optimal risk stratification after STEMI treated with PPCI. Follow‐up GLS and LVEF percentage change are the strongest predictors for early LV recovery and long term clinical outcome, respectively.

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The long-term prognostic value of E/e’ in patients with ST segment elevation myocardial infarction

Cited by 2 publications

References 29 publications

Role of Systolic Blood Pressure to Left Ventricular End-Diastolic Pressure Ratio in Prediction of Major Adverse Cardiovascular Events in Patients with ST-segment Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

Role of Systolic Blood Pressure to Left Ventricular End-Diastolic Pressure Ratio in Prediction of Major Adverse Cardiovascular Events in Patients with ST-segment Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

Incremental prognostic value of speckle tracking echocardiography and early follow‐up echo assessment in predicting left ventricular recovery after reperfusion for ST‐segment elevation myocardial infarction (STEMI)

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