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Impact of Coronary Microvascular Dysfunction on Functional Left Ventricular Remodeling and Diastolic Dysfunction.
Aldujeli, Ali; Tsai, Tsung-Ying; Haq, Ayman; Tatarunas, Vacis; Knokneris, Aurimas; Briedis, Kasparas; Unikas, Ramunas; Onuma, Yoshinobu; Brilakis, Emmanouil S; Serruys, Patrick W.
Afiliación
  • Aldujeli A; Lithuanian University of Health Sciences Kaunas Lithuania.
  • Tsai TY; CORRIB Research Centre for Advanced Imaging and Core Lab University of Galway Galway Ireland.
  • Haq A; Cardiovascular center Taichung Veterans General Hospital Taichung Taiwan.
  • Tatarunas V; Abbott Northwestern Hospital/Minneapolis Heart Institute Foundation Minneapolis MN.
  • Knokneris A; Lithuanian University of Health Sciences Kaunas Lithuania.
  • Briedis K; Klaipeda University Hospital Klaipeda Lithuania.
  • Unikas R; Lithuanian University of Health Sciences Kaunas Lithuania.
  • Onuma Y; Lithuanian University of Health Sciences Kaunas Lithuania.
  • Brilakis ES; CORRIB Research Centre for Advanced Imaging and Core Lab University of Galway Galway Ireland.
  • Serruys PW; University Hospital Galway Galway Ireland.
J Am Heart Assoc ; 13(9): e033596, 2024 May 07.
Article en En | MEDLINE | ID: mdl-38686863
ABSTRACT

BACKGROUND:

Coronary microvascular dysfunction (CMD) is a common complication of ST-segment-elevation myocardial infarction (STEMI) and can lead to adverse cardiovascular events. Whether CMD after STEMI is associated with functional left ventricular remodeling (FLVR) and diastolic dysfunction, has not been investigated. METHODS AND

RESULTS:

This is a nonrandomized, observational, prospective study of patients with STEMI with multivessel disease. Coronary flow reserve and index of microcirculatory resistance of the culprit vessel were measured at 3 months post-STEMI. CMD was defined as index of microcirculatory resistance ≥25 or coronary flow reserve <2.0 with a normal fractional flow reserve. We examined the association between CMD, LV diastolic dysfunction, FLVR, and major adverse cardiac events at 12-month follow-up. A total of 210 patients were enrolled; 59.5% were men, with a median age of 65 (interquartile range, 58-76) years. At 3-month follow-up, 57 patients (27.14%) exhibited CMD. After 12 months, when compared with patients without CMD, patients with CMD had poorer LV systolic function recovery (-10.00% versus 8.00%; P<0.001), higher prevalence of grade 2 LV diastolic dysfunction (73.08% versus 1.32%; P<0.001), higher prevalence of group 3 or 4 FLVR (11.32% versus 7.28% and 22.64% versus 1.99%, respectively; P<0.001), and higher incidence of major adverse cardiac events (50.9% versus 9.8%; P<0.001). Index of microcirculatory resistance was independently associated with LV diastolic dysfunction and adverse FLVR.

CONCLUSIONS:

CMD is present in ≈1 of 4 patients with STEMI during follow-up. Patients with CMD have a higher prevalence of LV diastolic dysfunction, adverse FLVR, and major adverse cardiac events at 12 months compared with those without CMD. REGISTRATION URL https//www.clinicaltrials.gov; Unique Identifier NCT05406297.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Remodelación Ventricular / Diástole / Infarto del Miocardio con Elevación del ST / Microcirculación Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Remodelación Ventricular / Diástole / Infarto del Miocardio con Elevación del ST / Microcirculación Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido