Dataset Information

Left ventricular diastolic dysfunction and E/E' ratio as the strongest echocardiographic predictors of reduced exercise capacity after acute myocardial infarction.

ABSTRACT: BACKGROUND:The mechanisms that determine reduced exercise capacity after acute myocardial infarction (AMI) are not fully understood, especially the relative role of left ventricular diastolic and systolic function. HYPOTHESIS:To evaluate the role of different diastolic and systolic function echocardiographic parameters as predictors of reduced functional capacity in patients after AMI. METHODS:One month after AMI, 225 patients (84% male; mean age, 55.1?±?10.9?years) were enrolled and underwent detailed echocardiography and cardiopulmonary exercise test on the same day. Systolic and diastolic function was evaluated by echocardiography according to the latest consensus recommendations, including tissue Doppler evaluation. Exercise capacity was evaluated with peak oxygen consumption (VO(2)). RESULTS:Peak VO(2) was significantly correlated with early diastolic tissue Doppler velocity (E') septal (r?=?0.42, P?

SUBMITTER: Fontes-Carvalho R

PROVIDER: S-EPMC6711017 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Left ventricular diastolic dysfunction and E/E' ratio as the strongest echocardiographic predictors of reduced exercise capacity after acute myocardial infarction.

Fontes-Carvalho Ricardo R Sampaio Francisco F Teixeira Madalena M Rocha-Gonçalves Francisco F Gama Vasco V Azevedo Ana A Leite-Moreira Adelino A

Clinical cardiology 20150223 4

<h4>Background</h4>The mechanisms that determine reduced exercise capacity after acute myocardial infarction (AMI) are not fully understood, especially the relative role of left ventricular diastolic and systolic function.<h4>Hypothesis</h4>To evaluate the role of different diastolic and systolic function echocardiographic parameters as predictors of reduced functional capacity in patients after AMI.<h4>Methods</h4>One month after AMI, 225 patients (84% male; mean age, 55.1 ± 10.9 years) were en ...[more]

PMID: 25707582

Similar Datasets

Project description:AimsThis study aimed to identify echocardiographic determinants of left ventricular thrombus (LVT) formation after acute anterior myocardial infarction (MI).Methods and resultsThis case-control study comprised 55 acute anterior MI patients with LVT as cases and 55 acute anterior MI patients without LVT as controls, who were selected from a cohort of consecutive patients with ischemic heart failure in our hospital. The cases and controls were matched for age, sex, and left ventricular ejection fraction. LVT was detected by routine/contrast echocardiography or cardiac magnetic resonance imaging during the first 3 months following MI. Formation of apical aneurysm after MI was independently associated with LVT formation [72.0% vs. 43.5%, odds ratio (OR) = 5.06, 95% confidence interval (CI) 1.65-15.48, P = 0.005]. Echocardiographic risk factors associated with LVT formation included reduced mitral annular plane systolic excursion (<7 mm, OR = 4.69, 95% CI 1.84-11.95, P = 0.001), moderate-severe diastolic dysfunction (OR = 2.71, 95% CI 1.11-6.57, P = 0.028), and right ventricular (RV) dysfunction [reduced tricuspid annular plane systolic excursion < 17 mm (OR = 5.48, 95% CI 2.12-14.13, P < 0.001), reduced RV fractional area change < 0.35 (OR = 3.32, 95% CI 1.20-9.18, P = 0.021), and enlarged RV mid diameter (per 5 mm increase OR = 1.62, 95% CI 1.12-2.34, P = 0.010)]. Reduced tricuspid annular plane systolic excursion (<17 mm) significantly associated with increased risk of LVT in anterior MI patients (OR = 3.84, 95% CI 1.37-10.75, P = 0.010), especially in those patients without apical aneurysm (OR = 5.12, 95% CI 1.45-18.08, P = 0.011), independent of body mass index, hypertension, anaemia, mitral annular plane systolic excursion, and moderate-severe diastolic dysfunction.ConclusionsRight ventricular dysfunction as determined by reduced TAPSE or RV fractional area change is independently associated with LVT formation in acute anterior MI patients, especially in the setting of MI patients without the formation of an apical aneurysm. This study suggests that besides assessment of left ventricular abnormalities, assessment of concomitant RV dysfunction is of importance on risk stratification of LVT formation in patients with acute anterior MI.

Project description:We report a genome-wide survey of early responses of the mouse heart transcriptome to acute myocardial infarction (AMI). For three regions of the left ventricle (LV), namely ischemic/infarcted tissue (IF), the surviving LV free wall (FW) and the interventricular septum (IVS), 36,899 transcripts were assayed at six time points from 15 min to 48 h post-AMI in both AMI and sham surgery mice. For each transcript, temporal expression patterns were systematically compared between AMI and sham groups, which identified 515 AMI-responsive genes in IF tissue, 35 in the FW, 7 in the IVS, with three genes induced in all three regions. Using the literature, we assigned functional annotations to all 519 nonredundant AMI-induced genes and present two testable models for central signaling pathways induced early post-AMI. First, the early induction of 15 genes involved in assembly and activation of the activator protein-1 (AP-1) family of transcription factors implicates AP-1 as a dominant regulator of earliest post-ischemic molecular events. Second, dramatic increases in transcripts for arginase 1 (ARG1), the enzymes of polyamine biosynthesis and protein inhibitor of nitric oxide synthase (NOS) activity indicates that NO production may be regulated, in part, by inhibition of NOS and coordinate depletion of the NOS substrate, L-arginine. ARG1 was the single most highly induced transcript in the database (121-fold in IF region) and its induction in heart has not been previously reported. Keywords: heart attack, mouse, time course, regional responses We report temporal and regional changes in steady state mRNA levels in the mouse LV following a surgically-induced AMI. Three regions of the infarcted LV were surveyed: IF, FW and IVS. For each region, mRNA levels were assayed at t=0 and six time points after occlusion of the left anterior descending coronary artery (t = 15 min, 1 h, 4 h, 12 h, 24 h, 48 h). As control, an identical time course was carried out in the mouse LV after sham surgery in which the suture was passed under the artery, but not ligated. For sham surgical mice and naïve mice (t=0), the IVS and the LV free wall were harvested and assayed. The AMI and sham time courses were repeated for a total of two independent repetitions of the experiment. For each repetition, 96 GeneChips were hybridized. Thus, for two repetitions, 192 GeneChips (2 x 96) were hybridized. In addition, the naïve time point was assayed a second time during Repetition 1 for six additional GeneChips (two tissues x three chips). The overall total number of samples is 198 GeneChips (192 + 6). Total RNA was isolated from each individual tissue sample. Equal weights of total RNA from 4-10 mice were combined for each LV region, time point and treatment. Copy RNA mixtures were synthesized from each total RNA pool and hybridized to the Affymetrix GeneChip set MG U74 v2 (A, B, and C) that carries 36,899 probe sets. The global normalization of fluorescence emissions for the 198 GeneChips used in this study and their conversion to relative transcript concentrations measured in relative fluorescence units (RFU) was conducted using Robust Multi-array Averaging (RMA; www.bioconductor.org). Each of the 198 Accessions is titled as follows: time point / treatment / tissue, repetition, GeneChip. The additional assays of naïve mice in Repetition 1 are labeled “Naive2”.

Dataset Information

Left ventricular diastolic dysfunction and E/E' ratio as the strongest echocardiographic predictors of reduced exercise capacity after acute myocardial infarction.

Publications

Left ventricular diastolic dysfunction and E/E' ratio as the strongest echocardiographic predictors of reduced exercise capacity after acute myocardial infarction.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets