Clinical significance of myocardial work parameters after acute myocardial infarction - Université de Rennes Accéder directement au contenu
Article Dans Une Revue European Heart Journal Open Année : 2022

Clinical significance of myocardial work parameters after acute myocardial infarction

Samy Aghezzaf
  • Fonction : Auteur
Guillaume Schurtz
  • Fonction : Auteur
Basile Verdier
  • Fonction : Auteur
Antoine Delobelle
  • Fonction : Auteur
Francesco Favata
  • Fonction : Auteur
Camille Garret
  • Fonction : Auteur
Claire Seunes
  • Fonction : Auteur
Amandine Coppin
  • Fonction : Auteur
Andrea Scotti
Azeem Latib
Juan Granada
  • Fonction : Auteur

Résumé

Aims To investigate the additional prognostic value of myocardial work (MW) parameters following acute myocardial infarction (AMI). Methods and results Between 2018 and 2020, 244 patients admitted in the cardiac intensive care unit in Lille University Hospital for AMI were included. One-month following AMI, comprehensive transthoracic echocardiography (TTE) was performed to assess parameters of myocardial function. Patients were then followed for major events (ME): cardiovascular death, heart failure, and unplanned coronary revascularization. At 1-month, half of the population was symptomatic (NYHA ≥ II), and medical therapy was almost optimized (angiotensin-converting enzyme inhibitor/angiotensin 2 receptor blocker in 95.5%, beta-blockers in 96.3%, DAPT in 94.7%, and statins in 97.1%). After a median follow-up of 681 (interquartile range: 538–840) days, ME occurred in 26 patients (10.7%). Patients presenting ME were older (65.5 ± 14.2 vs. 58.1 ± 12.1years, P = 0.005) with a higher prevalence of hypertension (65.4 vs. 36.2%, P = 0.004), more impaired left ventricular (LV) function as assessed by LV ejection fraction (P = 0.07), global longitudinal strain (P = 0.03), or MW parameters [P = 0.01 for global work efficiency (GWE)], and greater LV and left atrium dilatations (P = 0.06 for left ventricular end-diastolic volume index and P = 0.03 for left atrial volume index). After adjustment, GWE was the only TTE parameter independently associated with long-term occurrence of ME (P = 0.02). A GWE value <91% was selected to identify patients at higher ME risk (hazard ratio: 95% confidence interval) = 2.94 (1.36–6.35), P = 0.0041). Conclusion Lower GWE at 1 month after AMI is independently associated with higher ME rates. A GWE <91% can improve the post-AMI patient risk stratification.
Fichier principal
Vignette du fichier
oeac037.pdf (984.11 Ko) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte

Dates et versions

hal-03776182 , version 2 (20-01-2023)
hal-03776182 , version 1 (09-11-2023)

Identifiants

Citer

Augustin Coisne, Victor Fourdinier, Gilles Lemesle, Pascal Delsart, Samy Aghezzaf, et al.. Clinical significance of myocardial work parameters after acute myocardial infarction. European Heart Journal Open, 2022, 2 (3), pp.oeac037. ⟨10.1093/ehjopen/oeac037⟩. ⟨hal-03776182v2⟩
54 Consultations
33 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More