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The stress hyperglycaemia ratio is associated with left ventricular remodelling after first acute ST-segment
Shuai Meng1, Yong Zhu2, Kesen Liu2
1Department of Cardioloy, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Insights
High stress hyperglycaemia ratio (SHR) is linked to negative left ventricular remodelling after ST-segment elevation myocardial infarction (STEMI). This finding may help identify patients at risk for poor prognosis following a heart attack.
Area of Science:
- Cardiology
- Internal Medicine
- Biomedical Science
Background:
- Left ventricular negative remodelling post-STEMI significantly impacts patient prognosis.
- Predisposing factors and mechanisms of this remodelling remain incompletely understood.
- This study investigates the association between stress hyperglycaemia ratio (SHR) and left ventricular negative remodelling.
Purpose of the Study:
- To assess the correlation between the stress hyperglycaemia ratio (SHR) and left ventricular negative remodelling in patients with ST-segment elevation myocardial infarction (STEMI).
Main Methods:
- 127 patients with first-time, anterior STEMI were enrolled and divided into two equal subgroups based on the median SHR value.
- Echocardiography was performed at baseline and 6 months post-STEMI to measure left ventricular ejection fraction (LVEF), end-diastolic diameter (LVEDD), and end-systolic diameter (LVESD).
- Changes in these parameters (δLVEF, δLVEDD, δLVESD) were calculated and analyzed in relation to SHR levels using multivariable linear regression.
Main Results:
- Patients with a high SHR exhibited significantly lower LVEF and higher LVEDD and LVESD at 6 months post-STEMI compared to the low SHR group.
- Multivariable regression analysis confirmed that SHR was independently associated with changes in LVEF (δLVEF), LVEDD (δLVEDD), and LVESD (δLVESD).
- Specifically, higher SHR correlated with a decrease in LVEF and an increase in ventricular diameters.
Conclusions:
- The study demonstrates a significant correlation between the stress hyperglycaemia ratio (SHR) and left ventricular negative remodelling following STEMI.
- SHR may serve as a valuable predictor for adverse left ventricular remodelling in STEMI patients.
- These findings highlight the potential role of SHR in identifying patients at higher risk for poor outcomes after myocardial infarction.
Background:
Left ventricular negative remodelling after ST-segment elevation myocardial infarction (STEMI) is considered as the major cause for the poor prognosis. But the predisposing factors and potential mechanisms of left ventricular negative remodelling after STEMI remain not fully understood. The present research mainly assessed the association between the stress hyperglycaemia ratio (SHR) and left ventricular negative remodelling.
Methods:
We recruited 127 first-time, anterior, and acute STEMI patients in the present study. All enrolled patients were divided into 2 subgroups equally according to the median value of SHR level (1.191). Echocardiography was conducted within 24 h after admission and 6 months post-STEMI to measure left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD). Changes in echocardiography parameters (δLVEF, δLVEDD, δLVESD) were calculated as LVEF, LVEDD, and LVESD at 6 months after infarction minus baseline LVEF, LVEDD and LVESD, respectively.
Results:
In the present study, the mean SHR was 1.22 ± 0.25 and there was significant difference in SHR between the 2 subgroups (1.05 (0.95, 1.11) vs 1.39 (1.28, 1.50), p < 0.0001). The global LVEF at 6 months post-STEMI was significantly higher in the low SHR group than the high SHR group (59.37 ± 7.33 vs 54.03 ± 9.64, p = 0.001). Additionally, the global LVEDD (49.84 ± 5.10 vs 51.81 ± 5.60, p = 0.040) and LVESD (33.27 ± 5.03 vs 35.38 ± 6.05, p = 0.035) at 6 months after STEMI were lower in the low SHR group. Most importantly, after adjusting through multivariable linear regression analysis, SHR remained associated with δLVEF (beta = -9.825, 95% CI -15.168 to -4.481, p < 0.0001), δLVEDD (beta = 4.879, 95% CI 1.725 to 8.069, p = 0.003), and δLVESD (beta = 5.079, 95% CI 1.421 to 8.738, p = 0.007).
Conclusions:
In the present research, we demonstrated for the first time that SHR is significantly correlated with left ventricular negative remodelling after STEMI.
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