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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Changes of myocardial function in patients with non-ST-elevation acute coronary syndrome awaiting coronary

Bjørnar Grenne1, Christian Eek, Benthe Sjøli

  • 1Department of Medicine, Sørlandet Hospital, Arendal, Norway.

The American Journal of Cardiology
|April 21, 2010
PubMed

Insights

Myocardial function deteriorates in patients with non-ST elevation myocardial infarctions awaiting coronary angiography, especially those with acute occlusions. This subgroup shows no functional recovery post-revascularization.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Acute Coronary Syndromes

Background:

  • Optimal timing for coronary angiography in non-ST elevation acute coronary syndromes (NSTE-ACS) remains debated.
  • Current guidelines suggest an early invasive strategy within 12–48 hours.
  • Changes in myocardial function prior to angiography in NSTE-ACS patients are not fully understood.

Purpose of the Study:

  • To investigate alterations in global and regional myocardial function in patients with suspected NSTE-ACS awaiting coronary angiography.
  • To compare functional changes between NSTE myocardial infarctions (NSTEMIs) with and without acute coronary occlusions, and other NSTE-ACS subgroups.

Main Methods:

  • Speckle-tracking echocardiography was used to measure longitudinal and circumferential strain in 102 patients.
  • Measurements were taken at admission and immediately before coronary angiography (approx. 30 hours later).
  • Patients were categorized into NSTEMI, unstable angina pectoris, and noncoronary chest pain groups.

Main Results:

  • NSTEMI patients showed significant deterioration in longitudinal global strain (-16.1% to -15.0%, p<0.001) and regional strain in the infarct territory.
  • Patients with NSTEMIs due to acute coronary occlusions exhibited more pronounced worsening of longitudinal and circumferential strains compared to those without occlusions.
  • No significant changes in myocardial strain were observed in patients with unstable angina pectoris or noncoronary chest pain.

Conclusions:

  • Myocardial function declines in NSTEMI patients during the waiting period for coronary angiography.
  • Acute coronary occlusion is associated with the most significant functional deterioration.
  • NSTEMI patients with acute occlusions did not show functional recovery after revascularization.

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