Related Experiment Video
Updated: Dec 25, 2025
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Upstroke Time Per Cardiac Cycle as A Novel Parameter for Mortality Prediction in Patients with Acute Myocardial
Po-Chao Hsu1,2, Wen-Hsien Lee1,2,3, Wei-Chung Tsai1,2
1Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
Insights
Upstroke time per cardiac cycle (UTCC) effectively predicts long-term cardiovascular and overall mortality in acute myocardial infarction (AMI) patients. This novel parameter offers additive predictive value beyond traditional risk factors.
Area of Science:
- Cardiology
- Vascular Medicine
- Predictive Analytics
Background:
- Acute myocardial infarction (AMI) is a major global cause of mortality.
- Predicting mortality in AMI patients is crucial for timely, risk-stratified treatment.
- Upstroke time per cardiac cycle (UTCC) shows promise as a mortality predictor in elderly populations.
Purpose of the Study:
- To investigate the utility of UTCC in predicting cardiovascular (CV) and overall mortality in AMI patients.
- To compare the predictive performance of UTCC against ankle-brachial index (ABI) and conventional risk factors.
- To assess the additive predictive value of UTCC in established risk models.
Main Methods:
- 184 AMI patients were enrolled in a cardiac care unit.
- Ankle-brachial index (ABI) and UTCC were measured upon admission using an ABI-form device.
- Patients were followed for a median of 71 months for mortality outcomes.
Main Results:
- Higher UTCC independently predicted increased CV and overall mortality in multivariable analysis (P=0.033 and P<0.001).
- ABI was associated with mortality only in univariable analysis, losing significance in multivariable models.
- The addition of UTCC to a basic risk model significantly improved its predictive value for overall mortality (P<0.001).
Conclusions:
- UTCC is the first novel parameter shown to predict long-term mortality in AMI patients.
- UTCC serves as an independent predictor of long-term CV and overall mortality.
- UTCC provides additive predictive value, aiding in the identification of high-risk AMI patients for targeted interventions.
Abstract:
Background: Acute myocardial infarction (AMI) is one of the leading causes of death in the world. How to simply predict mortality for AMI patients is important because the appropriate treatment should be done for the patients with higher risk. Recently, a novel parameter of upstroke time per cardiac cycle (UTCC) in lower extremities was reported to be a good predictor of peripheral artery disease and mortality in elderly. However, there was no literature discussing the usefulness of UTCC for prediction of cardiovascular (CV) and overall mortality in AMI patients. Methods: 184 AMI patients admitted to the cardiac care unit were enrolled. Ankle-brachial index (ABI) and UTCC were measured by an ABI-form device in the same day of admission. Results: The median follow-up to mortality was 71 months. There were 36 CV and 124 overall mortality. Higher UTCC was associated with increased CV and overall mortality after multivariable analysis (P = 0.033 and P < 0.001, respectively). However, ABI was only associated with CV mortality and overall mortality in the univariable analysis but became insignificant after the multivariable analysis. In addition, after adding UTCC into a basic model including important clinical parameters, left ventricular ejection fraction, Charlson comorbidity index, and ABI, we found the basic model + UTCC had a better predictive value for overall mortality than the basic model itself (P < 0.001). Conclusions: Our study is the first one to evaluate the usefulness of UTCC in AMI patients for prediction of long-term mortality. Our study showed UTCC was an independent predictor of long-term CV and overall mortality and had an additive predictive value for overall mortality beyond conventional parameters. Therefore, screening AMI patients by UTCC might help physicians to identify the high-risk group with increased mortality.
More Related Videos
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:29Cardiac Cycle
During the cardiac cycle, blood flow through the heart is regulated entirely by changing pressure gradients. This sequence of events begins with the heart in a state of total relaxation, known as mid-to-late diastole, during which blood passively flows from...
01:30Acute Coronary Syndrome I: Introduction
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...