Prognosis after acute coronary syndrome in relation with ventricular-arterial coupling and left ventricular strain
Prognosis after acute coronary syndrome in relation with ventricular-arterial coupling and left ventricular strain
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DOI：
10.1016/j.ijcard.2016.06.173
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发表时间：
2016-10-01
影响因子：
3.5
通讯作者：
Wykretowicz, Andrzej
中科院分区：
文献类型：
--
作者：
Milewska, Agata;Minczykowski, Andrzej;Wykretowicz, Andrzej
背景资料：现代无创性左心室（LV）和动脉系统功能指标及其相互作用对急性冠状动脉综合征（ACS）患者预后的判断价值尚未明确。本研究旨在确定ACS患者的心室-动脉（VA）耦合、左室整体纵向收缩期峰值应变（GLPSS）、整体应变率（GSR）和舒张末期压30 mmHg时的舒张末期容积（V30）与长期临床结局的关系。单变量考克斯比例风险回归模型调整为各种临床因素，包括LV射血分数降低1.68（HR 2.4; 95% CI：1.04-5.6）; V30 > 107 mL（HR 4.5; 95% CI：1.9-10.6），GLPSS > -12.8%（HR 2.4; 95% CI：1.02-5.7），GSR N -0.96 1/s（HR 3.8; 95%CI：1.6-9.1）与风险增加显著相关。对同期接受治疗的ACS患者样本，LV功能的非侵入性指标及其与动脉系统的相互作用的异常值预测不良临床结局，与LV射血分数无关。(C)由Elsevier爱尔兰Ltd.出版
Background: The value of modern non-invasive indices of the left ventricle (LV) and arterial system function, and their interaction for determining prognosis in contemporarily treated patients with acute coronary syndrome (ACS) is notwell established. The study aimed to determine the association of ventricular-arterial (VA) coupling, LV global longitudinal peak systolic strain (GLPSS), global strain rate (GSR) and end-diastolic volume at end-diastolic pressure 30 mmHg (V30) with long-term clinical outcomes in patients with ACS.Methods: Echocardiography was applied in 569 ACS patients followed up for >12 months after hospitalization. Univariate Cox proportional hazard regression models adjusted to various clinical factors, including reduced LV ejection fraction 1.68 (HR 2.4; 95% CI: 1.04-5.6); V30 > 107 mL (HR 4.5; 95% CI: 1.9-10.6), GLPSS > -12.8% (HR 2.4; 95% CI: 1.02-5.7), GSR N -0.96 1/s (HR 3.8; 95% CI: 1.6-9.1) were robustly associated with increased hazard.Conclusions: With a sample of contemporarily treated ACS patients, abnormal values of non-invasive indices of LV function and their interaction with arterial system, predict adverse clinical outcomes, independently of LV ejection fraction. (C) 2016 Published by Elsevier Ireland Ltd.