급성 심근경색증 환자에서 관상동맥 중재술 후 허혈성 심근병증 예측인자
Predictors of Ischemic Cardiomyopathy in Patients with Acute Myocardial Infarction who Underwent Percutaneous Coronary Intervention
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Many patients with acute myocardial infarction (AMI) suffer from heart failure due to progressive ischemic left ventricular (LV) remodeling. This study investigated the predictors of ischemic cardiomyopathy (ICMP) in patients with AMI who underwent successful percutaneous intervention. Methods: A total of 547 patients with AMI were divided into two groups: ICMP (n = 66, 67.1 ± 11.9 years, 78.8% males) and non-ICMP (n = 481, 62.5 ± 12.2 years, 70.1% males). Results: On echocardiography, the LVEF was significantly decreased (41.7 ± 10.5 vs. 55.4 ± 10.3%, p < 0.001) but the LV end-diastolic (54.1 ± 7.2 vs. 49.3 ± 5.3 mm, p < 0.001) and systolic (42.1 ± 8.0 vs. 33.5 ± 6.0 mm, p < 0.001) dimensions significantly increased in the ICMP group compared with the non-ICMP group. According to multivariate logistic regression analysis, LVEF < 50% (odds ratio [OR] 8.722, 95% confidence interval [CI] 2.986–25.478, p < 0.001), LV end-diastolic dimension > 55 mm (OR 4.511, 95% CI 1.561–13.038, p = 0.005), and ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e’) ≥ 15 (OR 3.270, 95% CI 1.168–9.155, p = 0.024) were independent predictors of ICMP development. Conclusions: The present study demonstrates that a larger LV size, lower LV function, and increased E/e’ (≥ 15) were independent predictors of ICMP. Therefore, the development of ICMP should be carefully monitored in AMI patients with these features.
Abstract
Background/Aims: Many patients with acute myocardial infarction (AMI) suffer from heart failure due to progressive ischemic left ventricular (LV) remodeling. This study investigated the predictors of ischemic cardiomyopathy (ICMP) in patients with AMI who underwent successful percutaneous intervention. Methods: A total of 547 patients with AMI were divided into two groups: ICMP (n = 66, 67.1 ± 11.9 years, 78.8% males) and non-ICMP (n = 481, 62.5 ± 12.2 years, 70.1% males). Results: On echocardiography, the LVEF was significantly decreased (41.7 ± 10.5 vs. 55.4 ± 10.3%, p < 0.001) but the LV end-diastolic (54.1 ± 7.2 vs. 49.3 ± 5.3 mm, p < 0.001) and systolic (42.1 ± 8.0 vs. 33.5 ± 6.0 mm, p < 0.001) dimensions significantly increased in the ICMP group compared with the non-ICMP group. According to multivariate logistic regression analysis, LVEF < 50% (odds ratio [OR] 8.722, 95% confidence interval [CI] 2.986–25.478, p < 0.001), LV end-diastolic dimension > 55 mm (OR 4.511, 95% CI 1.561–13.038, p = 0.005), and ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e’) ≥ 15 (OR 3.270, 95% CI 1.168–9.155, p = 0.024) were independent predictors of ICMP development. Conclusions: The present study demonstrates that a larger LV size, lower LV function, and increased E/e’ (≥ 15) were independent predictors of ICMP. Therefore, the development of ICMP should be carefully monitored in AMI patients with these features.
참고문헌 (33)
- Hyun DW, "Clinical characteristics of acute myocardial infarction died during hospitalization", Korean Circ J, 28, pp.1518~1526 (1998)
- Hong YJ, "The long-term clinical outcomes after rescue percutaneous coronary intervention in patients with acute myocardial infarction", J Interv Cardiol, 16, pp.209~216 (2003)
- Puymirat E, "Association of changes in clinical characteristics and management with improvement in survival among patients with ST-elevation myocardial infarction", JAMA, 308, pp.998~1006 (2012)
- Sutton MG, "Left ventricular remodeling after myocardial infarction : pathophysiology and therapy", Circulation, 101, pp.2981~2988 (2000)
- Felker GM, "A standardized definition of ischemic cardiomyopathy for use in clinical research", J Am Coll Cardiol, 39, pp.210~218 (2002)
- Tenenbaum A, "Toward a redefinition of ischemic cardiomyopathy : is it an indivisible entity", J Am Coll Cardiol, 40, pp.205~206 (2002)
- Bart BA, "Clinical determinants of mortality in patients with angiographically diagnosed ischemic or nonischemic cardiomyopathy", J Am Coll Cardiol, 30, pp.1002~1008 (1997)
- Lang RM, "Recommendations for cardiac chamber quantification by echocardiography in adults : an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging", Eur Heart J Cardiovasc Imaging, 16, pp.233~270 (2015)
- Sawada SG, "Distinguishing ischemic cardiomyopathy from nonischemic dilated cardiomyopathy with coronary echocardiography", J Am Coll Cardiol, 19, pp.1223~1228 (1992)
- Yancy CW, "2013 ACCF", AHA guideline for the management of heart failure : a report of the American College of Cardiology Foundation, J Am Coll Cardiol, pp.2013, 62[DOI]
- Kim JH, "Multicenter cohort study of acute myocardial infarction in Korea-interim analysis of the Korea acute myocardial infarction registry-National Institutes of Health Registry", Circ J, 80, pp.1427~1436 (2016)
- Thygesen K, "Universal definition of myocardial infarction", J Am Coll Cardiol, 50, pp.2173~2195 (2007)
- Scanlon PJ, "ACC", AHA guidelines for coronary angiography. A report of the American College of Cardiology, J Am Coll Cardiol, pp.1999, 33[DOI]
- Kini AS, "Coronary angiography, lesion classification and severity assessment", Cardiol Clin, 24, pp.153~162 (2006)
- Smith SC Jr, "ACC", AHA, American Heart Association task force on practice guidelines (ACC, pp.AHA, SCAI Writing Committee to update the 2001 guidelines for percutaneous coronary intervention)[DOI]
- Bolognese L, "Left ventricular remodeling after primary coronary angioplasty : patterns of left ventricular dilation and long-term prognostic implications", Circulation, 106, pp.2351~2357 (2002)
- Konstam MA, "Left ventricular remodeling in heart failure : current concepts in clinical significance and assessment", JACC Cardiovasc Imaging, 4, pp.98~108 (2011)
- Zaliaduonyte-Peksiene D, "Left ventricular remodelling after acute myocardial infarction : impact of clinical, echocardiographic parameters and polymorphism of angiotensinogen gene", J Renin Angiotensin Aldosterone Syst, 15, pp.286~293 (2014)
- AHA, "AHA", ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease : 2006 update endorsed by the National Heart, Lung, and Blood Institute, 2006, pp.47, 2130~2139
- Hu K, "Long-term effects of beta-adrenergic blocking agent treatment on hemodynamic function and left ventricular remodeling in rats with experimental myocardial infarction : importance of timing of treatment and infarct size", J Am Coll Cardiol, 31, pp.692~700 (1998)
- 임상춘, "좌심실 부전증이 발생한 급성 심근경색증 환자에서 좌심실 기능 개선 관련 인자", Korean Circulation Journal, 37(3), pp.113~118 (2007), 대한심장학회
- Kim KH, "The comparison among low and high doses of imidapril, and combined imidapril with losartan in patients with ischemic heart failure after coronary intervention", Korean Circ J, 30, pp.965~972 (2000)
- Lee CH, "Remodeling and changes of systolic and diastolic functions of left ventricle after acute myocardial infarction : comparison according to killip class at admission", Korean Circ J, 28, pp.1727~1739 (1998)
- Floyd KC, "Age-based differences of percutaneous coronary intervention in the drug-eluting stent era", J Interv Cardiol, 19, pp.381~387 (2006)
- Guagliumi G, "Outcome in elderly patients undergoing primary coronary intervention for acute myocardial infarction : results from the controlled abciximab and device investigation to lower late angioplasty complications(CADILLAC)trial", Circulation, 110, pp.1598~1604 (2004)
- 윤현주, "급성 심근경색증 환자의 입원 중 합병증과 1년간 임상경과의 예측인자", 대한내과학회지, 77(6), pp.723~733 (2009), 대한내과학회
- 한정호, "급성 심근경색증으로 재관류 치료를 시행받은 환자에서 내원시 백혈구 수와 심근 손상의 관계", Korean Circulation Journal, 34(8), pp.735~742 (2004), 대한심장학회
- 김은정, "급성 심근경색증 환자의 예후인자로서 내원 시 혈당의 유용성", 대한내과학회지, 79(1), pp.23~31 (2010), 대한내과학회
- Kim EJ, "Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients", Int J Cardiol, 236, pp.9~15 (2017)
- Ishihara M, "Usefulness of combined white blood cell count and plasma glucose for predicting in-hospital outcomes after acute myocardial infarction", Am J Cardiol, 97, pp.1558~1563 (2006)
- Minicucci MF, "Heart failure after myocardial infarction : clinical implications and treatment", Clin Cardiol, 34, pp.410~414 (2011)
- Dokainish H, "Optimal noninvasive assessment of left ventricular filling pressures : a comparison of tissue Doppler echocardiography and B-type natriuretic peptide in patients with pulmonary artery catheters", Circulation, 109, pp.2432~2439 (2004)
- Arques S, "Current clinical applications of spectral tissue Doppler echocardiography(E", E' ratio)as a noninvasive surrogate for left ventricular diastolic pressures in the diagnosis of heart failure with preserved left ventricular systolic function, 2007, pp.5, 16~
