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Left ventricular function and coronary microcirculation in patients with mild reduced ejection fraction after STEMI
Yuliang Ma1, Lan Wang1, Wenying Jin1
1Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction; Center for Cardiovascular Translational Research, Department of Cardiology, Peking University People's Hospital, Beijing, China.
BMC Cardiovascular Disorders
|September 26, 2022
Summary
Heart failure with mildly reduced ejection fraction (HFmrEF) after ST-segment elevation myocardial infarction (STEMI) shows impaired left ventricular function and coronary microcirculation, comparable to severe cases. These patients require close monitoring and management.
Area of Science:
- Cardiology
- Echocardiography
- Myocardial Infarction
Background:
- Heart failure with mildly reduced ejection fraction (HFmrEF) shares characteristics with both HF with reduced EF (HFrEF) and HF with preserved EF (HFpEF).
- Understanding HFmrEF post-acute ST-segment elevation myocardial infarction (STEMI) is crucial for patient management.
Purpose of the Study:
- To evaluate left ventricular (LV) function and coronary microcirculation in patients with HFmrEF following STEMI.
- To compare these parameters between HFmrEF, HFrEF, and normal LV function groups.
Main Methods:
- 119 STEMI patients underwent speckle tracking imaging and myocardial contrast echocardiography.
- Patients were categorized into normal LVEF (≥50%), HFmrEF (40-50%), and HFrEF (≤40%) groups.
- Global longitudinal strain (GLS), myocardial perfusion index, and wall motion abnormalities were assessed.
Main Results:
- HFmrEF was present in 26.9% of patients.
- HFmrEF patients exhibited significantly impaired GLS and myocardial perfusion compared to the normal group.
- LV systolic function and coronary microcirculation in HFmrEF were comparable to those in the HFrEF group.
Conclusions:
- Global longitudinal strain (GLS) is a sensitive indicator of LV systolic dysfunction post-STEMI.
- HFmrEF patients demonstrate poorer LV function and microcirculation than normal, similar to HFrEF.
- Patients with HFmrEF after STEMI warrant increased clinical attention and tailored management strategies.
Keywords:
Acute ST-segment elevation myocardial infarctionCoronary microcirculationEjection fractionHeart failureMyocardial contrast echocardiographySpeckle tracking imagingMore Related Videos
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