Abstract
Background
Non-ST-segment elevation myocardial infarction (NSTEMI) is more common than ST-segment elevation myocardial infarction (STEMI), consisting of 60–70% of myocardial infarctions. When left ventricular (LV) pressure increases during early systole, regionally ischaemic myocardium with a reduced active force exhibit stretching. The aim of this study was to evaluate the role of this parameter in determining high risk angiographic territory involvement in NSTEMI patients.
Results
This study was a descriptive correlational research that was conducted on 96 patients with NSTEMI and a left ventricular ejection fraction ≥ 50% who underwent coronary angiography (CAG). Patients were divided into two groups based on having or not having high risk angiographic territory involvement in CAG. All patients underwent a transthoracic echocardiography during the first day of hospitalization and early systolic lengthening (ESL), duration of ESL (DESL), left ventricular global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e′) and peak systolic (s′) velocities were determined. The results of this study showed DESL, DESLLAD, and DESLLCX were longer in high risk angiographic territory group than other one (P value 0.016, 0.044, and 0.04, respectively). The logistic regression analysis showed among different variables, only age and ESLLAD had an independent association with high risk angiographic territory involvement (P = 0.01, odds ratio [OR] 1.09, 95% CI 1.021–1.164, and P = 0.024, odds ratio [OR] 1.243, 95% CI 1.029–1.50, respectively).
Conclusions
Assessment of myocardial ESLLAD by speckle-tracking echocardiography may be helpful in predicting high risk angiographic territory involvement in patients with NSTEMI. Indeed, a higher value can be considered as a high risk parameter which may show benefit of an early invasive strategy versus a conservative approach.
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Availability of data and materials
The datasets used and/or analyzed during this study are available from the corresponding author on reasonable request.
Abbreviations
- AMI:
-
Acute myocardial infarction
- NSTEMI:
-
Non-ST-segment elevation myocardial infarction
- STEMI:
-
ST-segment elevation myocardial infarction
- LV:
-
Left ventricle
- CAG:
-
Coronary angiography
- ESL:
-
Early systolic lengthening
- DESL:
-
Duration of early systolic lengthening
- E wave:
-
Pulsed-wave Doppler-derived transmitral early diastolic velocity
- A wave:
-
Pulsed-wave Doppler-derived transmitral late diastolic velocity
- e′:
-
Tissue-Doppler-derived mitral annular early diastolic velocity
- s′:
-
Tissue-Doppler-derived mitral annular peak systolic velocity
- LAD:
-
Left anterior descending artery
- LCX:
-
Left circumflex artery
- RCA:
-
Right coronary artery
- 2D:
-
Two-dimensional
- CAD:
-
Coronary artery disease
- LVEF:
-
Left ventricular ejection fraction
- TnI:
-
Troponin I
- HTN:
-
Hypertension
- DM:
-
Diabetes mellitus
- HLP:
-
Hyperlipidemia
- Chol:
-
Cholesterol
- BMI:
-
Body mass index
- LVGLS:
-
Left ventricular peak global longitudinal strain
- LA:
-
Left atrium
- DT:
-
Deceleration time
- IVS:
-
Interventricular septum
- LVIDd:
-
End-diastolic LV internal dimension
- PWT:
-
Posterior wall thickness
- SWT:
-
Septal wall thickness
- ACS:
-
Acute coronary syndrome
- PCI:
-
Percutaneous coronary intervention
- MI:
-
Myocardial infarction
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Acknowledgements
This study was Dr. Saeed Kavousi postgraduate thesis. The authors would like to thank all participants and hospital staff for their support in this research.
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MN designed the study, collected data and approved final version of manuscript, JY performed statistical analysis, SK reviewed literature and clinical data and interpreted results, and HP collected data and wrote the draft.
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Nabati, M., Kavousi, S., Yazdani, J. et al. The association between myocardial early systolic lengthening and high risk angiographic territory involvement in patients with non-ST-segment elevation myocardial infarction. J Ultrasound (2024). https://doi.org/10.1007/s40477-024-00885-w
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DOI: https://doi.org/10.1007/s40477-024-00885-w