Journal of Cardiovascular Medicine and Therapeutics

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us 44-1258650017

Research Article - Journal of Cardiovascular Medicine and Therapeutics (2017) Volume 1, Issue 3

Ratio E/E' and culprit artery predict ventricular remodeling after STEMI.

Background: ST-Elevation Myocardial Infarction (STEMI) is one of the most severe manifestations of atherosclerosis; prognosis is determined by remaining left ventricular function and the importance of systolic function has been well established. The aim of this study was to determine the E/E’ ratio, to predict the adverse ventricular remodeling (VR) in patients presenting with STEMI. Methods: From March 2011 to January 2012 we prospectively enrolled patients presenting with STEMI in the admission unit. Echocardiography was performed at presentation and 6 months after STEMI. VR was defined as the increase ≥ 20% of the left ventricular end diastolic volume. Uni and multivariate linear regression analyses were conducted. Results: Sixty-six STEMI patients (60.8 ± 10.3 years, 81% male) were recruited. In 56% the culprit artery was left anterior descending (LAD), right coronary artery in 39% and circumflex in 5%. VR was predicted by LAD as culprit artery (92%, p<0.001, rho 0.528), Septal E’ Velocity (p<0.001, rho 0.370) and the ratio E/E’ (p<0.001, -0.663). Six months after the STEMI patients with VR had lower left ventricular ejection fraction, and higher end systolic and diastolic volume. ROC analysis suggested an optimal cutoff for a E/E' ratio of ≥ 12 (S:91%, E:77%) at baseline to predict adverse VR. Multivariate analysis showed that the ratio E/E’, septal E´ velocity, culprit artery, and Killip Kimbal classification were predictors of adverse VR after STEMI (rho 0.750). Conclusion: E/E´ ratio ≥ 12 and LAD as the culprit artery are important predictors for adverse ventricular remodeling and should be considered for early medical treatment.

Author(s): Muratalla-González R1, Zaldivar-Fujigaki JL2, Van Der Harst P3, Aceves Chimal JL4, Morales- Portano JD1, García-García JF1, Merino-Rajme JA1*

Abstract Full Text PDF