Abnormal inter-ventricular diastolic mechanical delay in patients with ST-segment elevation myocardial infarction
Wenying Jin1, Chao Yu1, Lan Wang1
1Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China.
BMC Cardiovascular Disorders
|October 6, 2023
Summary
Right ventricular diastolic mechanical delay (RVMDd) in ST-segment elevation myocardial infarction (STEMI) patients is linked to worse outcomes. Early identification and monitoring of RVMDd can help prevent in-hospital complications.
Area of Science:
- Cardiology
- Cardiac Imaging
- Myocardial Infarction Research
Background:
- ST-segment elevation myocardial infarction (STEMI) significantly impacts cardiac function.
- Understanding ventricular mechanical relaxation patterns is crucial for managing STEMI patients.
- Diastolic dysfunction plays a key role in STEMI prognosis.
Purpose of the Study:
- To investigate ventricular mechanical relaxation patterns in STEMI patients.
- To determine the clinical influence of diastolic mechanical delay on STEMI outcomes.
- To identify factors associated with right ventricular diastolic mechanical delay (RVMDd).
Main Methods:
- Echocardiography was used to assess mitral and tricuspid valve diastolic opening times.
- Left ventricular diastolic mechanical delay (LVMDd) and right ventricular diastolic mechanical delay (RVMDd) were defined based on ventricular filling patterns.
- Statistical analysis, including logistic regression, was performed to identify associations.
Main Results:
- 65.8% of STEMI patients exhibited LVMDd, and 30.9% had RVMDd.
- Patients with RVMDd showed significantly increased in-hospital complications (61.6% vs. 41.0%).
- RVMDd was associated with reduced left ventricular global longitudinal strain, global work index, and global constructive work, alongside impaired diastolic function parameters (decreased mitral deceleration time, increased E/E').
Conclusions:
- Delayed right ventricular filling (RVMDd) correlates with more severe left ventricular systolic and diastolic dysfunction in STEMI.
- RVMDd is an independent predictor of adverse in-hospital events in STEMI patients.
- Increased clinical attention to STEMI patients with RVMDd is warranted to mitigate risks.
Keywords:
Diastolic ventricular mechanical delayGlobal longitudinal strainLeft ventricleLeft ventricular myocardial workMechanical synchronyMyocardial infarctionPulsed-wave Doppler echocardiographyMore Related Videos
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