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Association between the inflammatory response in the immediate post-acute phase and alteration of left ventricular function at 1 month in patients with STEMI undergoing primary PCI

Session Poster Session 2

Speaker Andras Mester

Congress : Acute Cardiovascular Care 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes: Inflammation
  • Session type : Poster Session
  • FP Number : P487

Authors : A Mester (Targu-Mures,RO), M Morariu (Targu-Mures,RO), D Opincariu (Targu-Mures,RO), N Rat (Targu-Mures,RO), R Hodas (Targu Mures,RO), S Korodi (Targu Mures,RO), I Benedek (Targu-Mures,RO), T Benedek (Targu-Mures,RO)

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Authors:
A Mester1 , M Morariu1 , D Opincariu1 , N Rat1 , R Hodas2 , S Korodi2 , I Benedek1 , T Benedek1 , 1University of Medicine and Pharmacy - Targu-Mures - Romania , 2County Emergency Hospital of Targu Mures - Targu Mures - Romania ,

Citation:

Background: The acute phase of an acute myocardial infarction (AMI) and the reperfusion of the ischemic myocardium are accompanied by an intense inflammatory response. Acute phase proteins such as high sensitive C-reactive protein (hs-CRP) play an important role in the healing process of the affected myocardium and may serve as long-term predictors for left ventricular (LV) remodeling. Purpose: We aimed to correlate the initial inflammatory response after an AMI (expressed by serum hs-CRP levels), with modifications of the LV systolic and diastolic function determined by speckle tracking echocardiography.
Methods: 25 patients with ST-segment elevation acute myocardial infarction (STEMI) treated by primary coronary angioplasty underwent baseline inflammation assessment at day 1 and 5. Patients were divided into two groups based on means of the day-5 hs-CRP values. All patients underwent speckle tracking echocardiography at day 3 and at 1-month follow-up with for evaluation of LV systolic and diastolic function, assessing the, LV ejection fraction (EF), global longitudinal strain (GLS), LV end systolic- and diastolic volumes (ESV and EDV) as well as LV systolic and diastolic remodeling.
Results: Patients with high hs-CRP serum levels at day-5 granted significantly higher baseline (-13.23 ± 0.67 vs. -16.33 ± 0.43, p=0.0009), and 1-month GLS rates (-11.47 ± 0.41 vs. -14.50 ± 0.45, p<0.0001), with significantly lower LVEF at baseline (p=0.05), but with no significant differences at 1-month follow-up (p=0.07). Significant correlations were observed between the levels of day-5 hs-CRP and baseline (r=0.539, p=0.006) and 1-month (r=0.581, p=0.002) GLS rates. The percentage of LV systolic remodeling (0.185 ± 0.01 vs. 0.282 ± 0.03, p=0.02) and LV diastolic remodeling (0.137 ± 0.01 vs. 0.248 ± 0.03, p=0.005) was significantly higher in the group with high day-5 hs-CRP levels. No significant differences were recorded in LV ESV (p=0.45) and EDV (p=0.5) at baseline and 1 month follow-up (LV ESV p=0.7 and EDV p=0.45)
Conclusions: Higher levels of day-5 hs-CRP levels were associated with altered LV systolic and diastolic function, as well as more expressed systolic and diastolic LV remodeling determined with speckle tracking echocardiography at baseline and 1-month follow-up. These findings suggest that these inflammatory biomarkers may be useful for the prediction of altered LV function and remodeling after an acute MI.



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