Key result
STEMI with initially preserved LVEF is linked to ~18% developing intermediate ejection fraction at one year.
Why the study?
The association of clinical features and cardiac structural and functional characteristics with progression of chronic heart failure after STEMI with preserved and reduced LVEF was not well defined.
Cohort (n=120)
Within one year after STEMI, a significant proportion of patients with initially preserved LVEF experience deterioration in systolic and diastolic function.
May warrant serial LVEF surveillance after STEMI despite initial preservation; leaves open whether early detection alters outcomes in this subgroup.
Objective. To identify the association of a number of clinical features and structural and functional characteristics of the heart with the progression of chronic heart failure (CHF) in patients one year after ST-segment elevation myocardial infarction (MI) (STEMI) with preserved and reduced left ventricular ejection fraction (EF) (LVEF). Design and methods. 120 patients with STEMI were included in a prospective study. During the study, all patients underwent an echocardiographic study using a Sonos 2500 device (Hewlett Packard, USA) on the 1st day (point I), on the 12th day (point II) of hospitalization, and also after 1 year (point III). Depending on the parameters of EF on the 1st day of the disease, the total sample of patients was divided into two: the 1st group — with preserved LVEF was represented by 86 (71,7 %), the 2nd group — with a reduced LVEF was represented by 34 (28,3 %) patients. Results. A total of 19 (15,8 %) adverse events were registered. In two cases, a fatal outcome (1,7 %) was recorded, the cause of which was repeated MI, in five (4,2 %) patients decompensation of СHF was noted, in eight (6,7 %) patients a clinic of progressive angina was traced, in four (3, 3 %) of patients were diagnosed recurrent MI. Deterioration of systolic and diastolic function was established one year after STEMI with preserved (≥ 50 %) LVEF: 17,6 % of patients began to correspond to the intermediate range of EF (40-49 %), the number of patients with diastolic dysfunction increased by 10 % compared to with acute study. Conclusions. Within a year after a STEMI with initially preserved LVEF, there is a deterioration in myocardial function in the form of a decrease in myocardial contractility and an increase in the number of patients with diastolic dysfunction.
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Каретникова et al. (2022) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=120). Preserved LVEF vs. Reduced LVEF was evaluated on Adverse events and deterioration of systolic and diastolic function. Within one year after STEMI with initially preserved LVEF, myocardial function deteriorated, with 17.6% of patients transitioning to intermediate ejection fraction.
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