Tor Biering-Sørensen1, Jan Skov Jensen2, Sune Pedersen3, Søren Galatius3, Soren Hoffmann3, Magnus Thorsten Jensen3, Rasmus Mogelvang3. 1. Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark; Institute of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: tor.biering@gmail.com. 2. Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark; Institute of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 3. Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
Abstract
BACKGROUND: Doppler tissue imaging (DTI) detects early signs of left ventricular (LV) dysfunction; however, the prognostic significance of DTI after ST-segment elevation myocardial infarction (STEMI) is unknown. The aim of this study was to evaluate the prognostic value of DTI after STEMI in patients treated with primary percutaneous coronary intervention. METHOD: In total, 391 patients who were admitted with STEMIs and treated with primary percutaneous coronary intervention were prospectively included. All participants were examined by echocardiography 2 days (interquartile range, 1-3 days) after STEMI. Longitudinal systolic (s'), early diastolic (e'), and late diastolic (a') myocardial velocities were measured using color DTI at six mitral annular sites and averaged to provide global estimates. RESULTS: The median follow-up period was 25 months (interquartile range, 19-32 months). The primary end point was a composite of death, heart failure, or a new myocardial infarction. Patients with low global systolic function (s') or low global diastolic function (e') had >2 times greater risk for the combined end point compared with patients with high global s' (hazard ratio, 2.60; 95% confidence interval, 1.64-4.13; P < .001) or e' (hazard ratio, 2.26; 95% confidence interval, 1.44-3.55; P < .001), respectively. After adjustment for age, gender, peak troponin I, previous myocardial infarction, LV ejection fraction, LV mass index, and LV dimension in a multivariate Cox model, patients with low values of both global s' and e' remained at significantly higher risk than patients with high s' and/or e' (hazard ratio, 1.69; 95% confidence interval, 1.02-2.81; P = .043). CONCLUSIONS: A pattern of low systolic and diastolic performance as assessed by DTI is a paramount marker of adverse prognosis for patients with STEMIs independent of conventional echocardiographic parameters. DTI velocities should be evaluated together as they interact with the prognosis.
BACKGROUND: Doppler tissue imaging (DTI) detects early signs of left ventricular (LV) dysfunction; however, the prognostic significance of DTI after ST-segment elevation myocardial infarction (STEMI) is unknown. The aim of this study was to evaluate the prognostic value of DTI after STEMI in patients treated with primary percutaneous coronary intervention. METHOD: In total, 391 patients who were admitted with STEMIs and treated with primary percutaneous coronary intervention were prospectively included. All participants were examined by echocardiography 2 days (interquartile range, 1-3 days) after STEMI. Longitudinal systolic (s'), early diastolic (e'), and late diastolic (a') myocardial velocities were measured using color DTI at six mitral annular sites and averaged to provide global estimates. RESULTS: The median follow-up period was 25 months (interquartile range, 19-32 months). The primary end point was a composite of death, heart failure, or a new myocardial infarction. Patients with low global systolic function (s') or low global diastolic function (e') had >2 times greater risk for the combined end point compared with patients with high global s' (hazard ratio, 2.60; 95% confidence interval, 1.64-4.13; P < .001) or e' (hazard ratio, 2.26; 95% confidence interval, 1.44-3.55; P < .001), respectively. After adjustment for age, gender, peak troponin I, previous myocardial infarction, LV ejection fraction, LV mass index, and LV dimension in a multivariate Cox model, patients with low values of both global s' and e' remained at significantly higher risk than patients with high s' and/or e' (hazard ratio, 1.69; 95% confidence interval, 1.02-2.81; P = .043). CONCLUSIONS: A pattern of low systolic and diastolic performance as assessed by DTI is a paramount marker of adverse prognosis for patients with STEMIs independent of conventional echocardiographic parameters. DTI velocities should be evaluated together as they interact with the prognosis.
Authors: Philip Brainin; Sune Haahr-Pedersen; Morten Sengeløv; Flemming Javier Olsen; Thomas Fritz-Hansen; Jan Skov Jensen; Tor Biering-Sørensen Journal: Int J Cardiovasc Imaging Date: 2017-12-11 Impact factor: 2.357
Authors: Flemming J Olsen; Peter G Jørgensen; Rasmus Møgelvang; Jan S Jensen; Thomas Fritz-Hansen; Jan Bech; Jacob Sivertsen; Tor Biering-Sørensen Journal: Int J Cardiovasc Imaging Date: 2015-07-21 Impact factor: 2.357
Authors: Maria Dons; Tor BieringSørensen; Jan Skov Jensen; Thomas Fritz-Hansen; Jan Bech; Martina Chantal de Knegt; Jacob Sivertsen; Flemming Javier Olsen; Rasmus Mogelvang Journal: J Atr Fibrillation Date: 2015-06-30
Authors: Morten Sengeløv; Peter Godsk; Niels Eske Bruun; Flemming Javier Olsen; Thomas Fritz-Hansen; Tor Biering-Sorensen Journal: Open Heart Date: 2021-01
Authors: Thomas Hvid Jensen; Peter Juhl-Olsen; Bent Roni Ranghøj Nielsen; Johan Heiberg; Christophe Henri Valdemar Duez; Anni Nørgaard Jeppesen; Christian Alcaraz Frederiksen; Hans Kirkegaard; Anders Morten Grejs Journal: Scand J Trauma Resusc Emerg Med Date: 2021-02-19 Impact factor: 2.953
Authors: Tor Biering-Sørensen; Jan Skov Jensen; Sune H Pedersen; Søren Galatius; Thomas Fritz-Hansen; Jan Bech; Flemming Javier Olsen; Rasmus Mogelvang Journal: PLoS One Date: 2016-06-27 Impact factor: 3.240