Prognostic value of E/e' ratio and its change over time in ST-segment elevation myocardial infarction with preserved left ventricular ejection fraction in the reperfusion era
Copyright © 2024. Published by Elsevier Ltd..
BACKGROUND: The ratio of early diastolic mitral inflow velocity to mitral annular velocity (E/e') is a prognostic factor in patients with ST-segment elevation myocardial infarction (STEMI). However, data are lacking on long-term outcomes and longitudinal changes in E/e' in patients with preserved left ventricular ejection fraction (LVEF) in the reperfusion era.
METHODS: This is a pre-specified echocardiographic substudy of a randomized controlled trial evaluating the efficacy of beta-blockers in STEMI patients with LVEF ≥40 % after primary percutaneous coronary intervention (PCI). Patients were divided into 2 groups according to E/e' at discharge: ≤14 (normal E/e' group) or > 14 (high E/e' group). The primary outcome was a composite of all-cause death, myocardial infarction, stroke, acute coronary syndrome, and heart failure hospitalization. We also assessed longitudinal changes in E/e' and conducted a landmark analysis using E/e' at 1 year after STEMI.
RESULTS: There were 173 and 38 patients in the normal and high E/e' groups, respectively. During a median follow-up of 3.9 years, the primary outcome occurred in 19 patients (11.0 %) and 10 patients (26.3 %) in the normal and high E/e' groups, respectively. The cumulative incidence of the primary outcome was higher in the high E/e' group than in the normal E/e' group (21.9 % vs. 7.1 % at 3 years; log-rank p = 0.013). E/e' in the high E/e' group decreased over time (p < 0.001), but remained higher than in the normal E/e' group at 1 year after STEMI (13.7 ± 5.3 vs. 8.6 ± 2.3, p < 0.001). E/e' > 14 at 1 year was also associated with poor outcomes (log-rank p = 0.008). A sensitivity analysis using multivariate Cox proportional hazards regression models yielded consistent results.
CONCLUSION: High E/e' at discharge is associated with poor long-term outcomes in STEMI patients with preserved LVEF after primary PCI, which may be explained by persistent high E/e' late after STEMI.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of cardiology - (2024) vom: 14. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Miyake, Makoto [VerfasserIn] |
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| Links: |
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| Themen: |
Echocardiography |
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| Anmerkungen: |
Date Revised 22.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.jjcc.2024.03.002 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369803221 |
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| 100 | 1 | |a Miyake, Makoto |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic value of E/e' ratio and its change over time in ST-segment elevation myocardial infarction with preserved left ventricular ejection fraction in the reperfusion era |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 22.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024. Published by Elsevier Ltd. | ||
| 520 | |a BACKGROUND: The ratio of early diastolic mitral inflow velocity to mitral annular velocity (E/e') is a prognostic factor in patients with ST-segment elevation myocardial infarction (STEMI). However, data are lacking on long-term outcomes and longitudinal changes in E/e' in patients with preserved left ventricular ejection fraction (LVEF) in the reperfusion era | ||
| 520 | |a METHODS: This is a pre-specified echocardiographic substudy of a randomized controlled trial evaluating the efficacy of beta-blockers in STEMI patients with LVEF ≥40 % after primary percutaneous coronary intervention (PCI). Patients were divided into 2 groups according to E/e' at discharge: ≤14 (normal E/e' group) or > 14 (high E/e' group). The primary outcome was a composite of all-cause death, myocardial infarction, stroke, acute coronary syndrome, and heart failure hospitalization. We also assessed longitudinal changes in E/e' and conducted a landmark analysis using E/e' at 1 year after STEMI | ||
| 520 | |a RESULTS: There were 173 and 38 patients in the normal and high E/e' groups, respectively. During a median follow-up of 3.9 years, the primary outcome occurred in 19 patients (11.0 %) and 10 patients (26.3 %) in the normal and high E/e' groups, respectively. The cumulative incidence of the primary outcome was higher in the high E/e' group than in the normal E/e' group (21.9 % vs. 7.1 % at 3 years; log-rank p = 0.013). E/e' in the high E/e' group decreased over time (p < 0.001), but remained higher than in the normal E/e' group at 1 year after STEMI (13.7 ± 5.3 vs. 8.6 ± 2.3, p < 0.001). E/e' > 14 at 1 year was also associated with poor outcomes (log-rank p = 0.008). A sensitivity analysis using multivariate Cox proportional hazards regression models yielded consistent results | ||
| 520 | |a CONCLUSION: High E/e' at discharge is associated with poor long-term outcomes in STEMI patients with preserved LVEF after primary PCI, which may be explained by persistent high E/e' late after STEMI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Echocardiography | |
| 650 | 4 | |a Left ventricular diastolic function | |
| 650 | 4 | |a Primary percutaneous coronary intervention | |
| 650 | 4 | |a ST-segment elevation myocardial infarction | |
| 700 | 1 | |a Izumi, Chisato |e verfasserin |4 aut | |
| 700 | 1 | |a Watanabe, Hiroki |e verfasserin |4 aut | |
| 700 | 1 | |a Ozasa, Neiko |e verfasserin |4 aut | |
| 700 | 1 | |a Morimoto, Takeshi |e verfasserin |4 aut | |
| 700 | 1 | |a Matsutani, Hayato |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Shuichi |e verfasserin |4 aut | |
| 700 | 1 | |a Ohtani, Yuya |e verfasserin |4 aut | |
| 700 | 1 | |a Baba, Megumi |e verfasserin |4 aut | |
| 700 | 1 | |a Sakamoto, Jiro |e verfasserin |4 aut | |
| 700 | 1 | |a Tamaki, Yodo |e verfasserin |4 aut | |
| 700 | 1 | |a Enomoto, Soichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kondo, Hirokazu |e verfasserin |4 aut | |
| 700 | 1 | |a Tamura, Toshihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Nakagawa, Yoshihisa |e verfasserin |4 aut | |
| 700 | 1 | |a Kimura, Takeshi |e verfasserin |4 aut | |
| 700 | 0 | |a CAPITAL-RCT Investigators |e verfasserin |4 aut | |
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