Early Predictors of Heart Failure Progression in Patients After Myocardial Infarction

Area of Science:

• Cardiology
• Internal Medicine
• Biomedical Engineering

Background:

• Chronic heart failure (CHF) is a significant complication following ST-segment elevation myocardial infarction (STEMI).
• Identifying early predictors of CHF progression is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To identify early predictors for the progression of chronic heart failure (CHF) in patients who have experienced ST-segment elevation myocardial infarction (STEMI).

Main Methods:

• The study involved 113 STEMI patients monitored for 48 weeks.
• 24-hour ECG monitoring assessed heart rhythm turbulence (HRT) and heart rhythm variability (HRV).
• XStrain 2D echocardiography evaluated left ventricular (LV) strain and volumes, alongside brain natriuretic peptide (BNP) measurements.

Main Results:

• Patients with CHF progression showed increased LV end-diastolic dimension and volumes, and decreased global longitudinal and radial strain.
• Pathological HRT was more prevalent in the progression group, while the stable group exhibited improved HRV.
• CHF progression correlated with abnormal turbulence onset (TO), disturbed HRT, elevated BNP, increased LV end-systolic diameter (ESD), and reduced GLS, GCS, and GRS.

Conclusions:

• Key markers for CHF progression post-STEMI include abnormal TO, disturbed HRT, elevated BNP, increased LV ESD, and reduced GLS, GCS, and GRS.
• Combined assessment of HRT, LV ESD, and GLS at 7-9 days post-STEMI can identify high-risk patients for CHF progression.