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The predictive value of mechanocardiographic measurements with respect to myocardial infarction
Insights
Systolic time intervals (STI) can predict future myocardial infarction (MI) in men. Prolonged STI at initial examination indicated a higher risk of developing new MI during follow-up.
Area of Science:
- Cardiology
- Preventive Medicine
- Biomedical Engineering
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality.
- Early detection of individuals at risk for myocardial infarction (MI) is crucial for preventive strategies.
- Mechanocardiography offers non-invasive methods to assess cardiac function.
Purpose of the Study:
- To evaluate the predictive value of systolic time intervals (STI) and apex cardiographic A wave amplitude for incident coronary heart disease.
- To determine if mechanocardiographic parameters can identify asymptomatic individuals at risk for future myocardial infarction.
Main Methods:
- 1231 men aged 17-64 years were studied.
- Systolic time intervals (STI) and apex cardiographic A wave amplitude were measured.
- A 4-year follow-up was conducted to record new myocardial infarction (MI) events.
Main Results:
- Men who developed MI during follow-up had significantly prolonged STI at baseline, even after adjusting for confounding factors.
- Apex cardiographic A wave amplitude did not consistently predict MI.
- Higher quintiles of electromechanical systole (QS2) and pre-ejection period (PEP) were associated with increased MI incidence.
Conclusions:
- Myocardial dysfunction, detectable by mechanocardiography using STI, predicts future myocardial infarction in asymptomatic subjects.
- STI, specifically QS2 and PEP, are significant positive correlates of MI incidence.
- Mechanocardiography shows promise as a tool for predicting cardiovascular events.
Abstract:
Systolic time intervals (STI) and apex cardiographic A wave amplitude were measured to assess their predictive value for coronary heart disease in 1231 men aged from 17 to 64 years. Thirteen men had had a previous myocardial infarction (MI) and during a 4-year follow-up there were 30 new MI cases. Men with previous MI showed prolongations of the STI, but when the STI were corrected for the effect of age, heart rate, blood pressure and body size, the differences did not remain statistically significant. On the other hand, men who had MI during the follow-up, had significantly prolonged STI at the initial examination, and this difference remained significant also after correction for the other factors. The apexcardiographic A wave did not show any consistent relationship either to the presence of old MI or the occurrence of a new MI. Analysis of the incidence of new MI by quintiles of STI showed that the 4-year incidence of MI was related to the duration of electromechanical systole (QS2) and pre-ejection period (PEP). 80% of new MI cases were in the two highest quintiles of QS2 and MI incidence increased gradually from 0.7% in the quintile with shortest PEP to 6.9% in the highest quintile of PEP. Multiple regression analyses revealed that the duration of QS2 or PEP had a significant, positive correlation with the incidence of MI, even when the effect of age and blood pressure was taken into account. In conclusion, myocardial dysfunction detectable by means of mechanocardiography in asymptomatic subjects has a predictive value with respect to future myocardial infarction.