A study to observe the association of left ventricular ejection fraction and wall motion score index with duration of early systolic lengthening in patients with non-ST-elevation acute coronary syndrome

Dayanand Paswan, Lipika Adhikari, Sandip Sarkar
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Abstract

Background: Management of non-ST elevation myocardial infarction acute coronary syndrome (NSTEMI ACS) patients is not well defined as that of ST elevation myocardial infarction. The accuracy of results of conventional echocardiography is significantly compromised when imaging is suboptimal, myocardial damage is in small areas, and compensatory hyperkinesias of healthy segment. Aims and Objectives: Duration of early systolic lengthening (DESL) may be employed to identify early myocardial ischemia and thus, may help to prepare treatment strategies for NSTEMI patients. Materials and Methods: A total of 57 patients with NSTEMI ACS attending the cardiology department were included in the study group. Results: More than 80% of patients of NSTEMI have normal or near normal ejection fraction and wall motion score index. In our study, the DESL is prolonged in a significant number of non-ST-elevation acute coronary syndrome patients. Conclusion: As DESL is afterload independent, it is superior to global longitudinal strain in assessing myocardial damage. Several studies including ourselves show that DESL of <50 ms may be the cutoff value to reveal minimal myocardial damage.
观察非 ST 段抬高急性冠状动脉综合征患者左心室射血分数和室壁运动评分指数与早期收缩期延长持续时间的关系的研究
背景:非 ST 段抬高型心肌梗死急性冠状动脉综合征(NSTEMI ACS)患者的管理与 ST 段抬高型心肌梗死的管理不同。当成像效果不理想、心肌损伤范围较小以及健康节段出现代偿性高运动时,传统超声心动图结果的准确性就会大打折扣。目的和目标:早期收缩期延长持续时间(DESL)可用于识别早期心肌缺血,从而帮助制定 NSTEMI 患者的治疗策略:研究组共纳入了57名在心内科就诊的NSTEMI ACS患者:80%以上的NSTEMI患者射血分数和室壁运动评分指数正常或接近正常。在我们的研究中,大量非 ST 段抬高型急性冠脉综合征患者的 DESL 延长:结论:DESL不受后负荷影响,因此在评估心肌损伤方面优于整体纵向应变。包括我们自己在内的多项研究表明,DESL<50 ms可能是显示最小心肌损伤的临界值。
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