Rapid Fire Abstracts
Sören Backhaus, MD
Consultant Cardiologist
Department of Cardiology, Heart Centre, Kerckhoff-Clinic Bad Nauheim, Germany
Sören Backhaus, MD
Consultant Cardiologist
Department of Cardiology, Heart Centre, Kerckhoff-Clinic Bad Nauheim, Germany
Jan Sebastian Wolter
physician
Kerckhoff-Klinik, Germany
Thomas Stiermaier, MD
Cardiologist
University Heart Center Lübeck, Germany
Alexander Schulz, MD
Dr.
Harvard Medical School / BIDMC, Germany
Torben Lange, MD
Resident
University Medical Center Göttingen, Germany, Germany
Shelby Kutty, MD
Dr.
Taussig Heart Center, USA
Maren Weferling, MD
Senior Physician
Kerckhoff Klinik, Germany
Julia Treiber, MD
senior physician
Kerckhoff Klinik, Germany
Johannes Kowallick, MD
Prof.
University Medical Center Göttingen, Germany, Germany
Gerd Hasenfuß, MD
Prof
University Medical Center Göttingen, Germany, Germany
Andreas Rolf, MD
Senior Cardiologist
Kerckhoff Klinikum Bad Nauheim, Germany
Samuel Sossalla, MD
chief medical officer
Kerckhoff Klinik, Germany
Holger Thiele, MD
Director
Heart Center Leipzig, Germany
Ingo Eitel, MD
Director
University Heart Center Lübeck, Germany
Andreas Schuster, MD, PhD
Cardiologist
University Medical Center Göttingen, Germany
Load dependence on LV strain is under constant debate with its interference with prognostic implications remaining unclear. Consequently, we sought to investigate their interaction and prognostic value following acute myocardial infarction (AMI) using state of the art cardiac magnetic resonance (CMR) imaging.
Methods:
In total, 1235 patients (n=795 ST-elevation (STEMI) and 440 non-STEMI) underwent CMR in median 3 days following AMI. Infarct characteristics were described by CMR using tissue characterisation (infarct size, microvascular obstruction, area at risk) and deformation imaging including left ventricular (LV) global longitudinal and circumferential strain (GLS/GCS). Non-invasive hemodynamic indices included effective arterial elastance Ea (end-systolic pressure (ESP)/stroke volume) and the non-geometric LV end-systolic afterload index NGI ((ESP*LV end-systolic volume (ESV))/LV mass) for estimation of LV afterload. LV contractility was assessed using end-systolic elastance Ees (ESP/LV ESV). Ventriculo-arterial coupling was described as Ea/Ees. Major adverse cardiac events (MACE) were recorded within the first year.
Results:
All hemodynamic indices were impaired in patients with MACE during follow-up compared to patients without (p< 0.001-0.005). Ventriculo-arterial coupling showed the highest correlation to infarct properties (infarct size r=0.51, p< 0.001) and deformation imaging (GLS r=0.54, GCS r=0.72, p< 0.001). GLS and GCS were associated with MACE independently of all hemodynamic indices (p< 0.001 for all except of GCS-Ea/Ees p=0.024).
Conclusion:
Non-invasive hemodynamic indices are associated with outcome following AMI with ventriculo-arterial coupling showing the most prominent association to infarct properties and outcome. GCS shows higher correlation to hemodynamic indices compared to GLS whilst both are independent predictors for MACE.