التفاصيل البيبلوغرافية
| العنوان: |
Echocardiographic findings in cardiogenic shock due to acute myocardial infarction versus heart failure. |
| المؤلفون: |
Singam, Narayana Sarma V.1,2,3 (AUTHOR) singamnv@gmail.com, Tabi, Meir4 (AUTHOR), Wiley, Brandon4 (AUTHOR), Anavekar, Nandan4 (AUTHOR), Jentzer, Jacob4 (AUTHOR) |
| المصدر: |
International Journal of Cardiology. Aug2023, Vol. 384, p38-47. 10p. |
| مصطلحات موضوعية: |
*CARDIOGENIC shock, *MYOCARDIAL infarction, *HEART failure, *CARDIAC contraction, *LEFT ventricular dysfunction, *INTENSIVE care patients |
| مستخلص: |
Acute myocardial infarction (AMI) is the prototypical cause of cardiogenic shock (CS), yet CS due to heart failure (HF-CS) is increasingly common. Little is known regarding cardiac function in AMI-CS versus HF-CS. We compared transthoracic echocardiography (TTE) findings in AMI-CS versus HF-CS and identified predictors of mortality in AMI-CS patients. We performed a single-center, retrospective analysis of CS admissions between 2007 and 2018. We compared baseline demographic and TTE parameters in patients with AMI-CS and HF-CS as well as ST elevation myocardial infarction (STEMI)-CS versus non-ST elevation myocardial infarction (NSTEMI)-CS. We included 893 unique patients, including 581 (65%) with AMI-CS. AMI-CS patients were older but had lower illness severity and non-cardiac comorbidity burden. AMI-CS patients had better left ventricular function (LVEF 35% versus 28%), lower biventricular filling pressures, and higher stroke volume versus those with HF-CS. Among TTE measurements, myocardial contraction fraction had the highest discrimination for mortality in AMI-CS (AUC: 0.64); AUC values for LVEF and SOFA score were 0.61 and 0.65, respectively. Differences in TTE findings between STEMI-CS versus NSTEMI-CS were modest. There were no significant differences in unadjusted or adjusted in-hospital mortality between AMI-CS and HF-CS (31% versus 35%) or STEMI-CS and NSTEMI-CS (31% versus 30%) groups (all p > 0.05). Patients with HF-CS and AMI-CS differ in terms of clinical and TTE variables yet have similar prognoses. TTE is useful in determining prognosis of patients admitted with AMI-CS and may allow for early triage and directed therapy. • Echocardiography provides insights into mortality in cardiogenic shock patients in the cardiac intensive care unit. • Myocardial contractile fraction is a novel marker of mortality in patients with acute MI and cardiogenic shock. • Severe left ventricular dysfunction is a marker of mortality in patients with acute MI and cardiogenic shock. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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