دورية أكاديمية

Regional wall motion abnormalities predict culprit lesions in patients presenting with acute chest pain

التفاصيل البيبلوغرافية
العنوان: Regional wall motion abnormalities predict culprit lesions in patients presenting with acute chest pain
المؤلفون: Roggel, A, Hendricks, S, Dykun, I, Balcer, B, Al-Rashid, F, Risse, J, Kill, C, Totzeck, M, Rassaf, T, Mahabadi, A A
المصدر: European Heart Journal ; volume 42, issue Supplement_1 ; ISSN 0195-668X 1522-9645
بيانات النشر: Oxford University Press (OUP)
سنة النشر: 2021
مصطلحات موضوعية: Cardiology and Cardiovascular Medicine
الوصف: Background Current ESC guidelines for non-ST-segment elevation myocardial infarction suggest the utilization of echocardiography in patients with inconclusive initial electrocardiography and cardiac enzymes. Besides detection of alternative pathologies associated with chest pain, echocardiography can screen for wall motion abnormalities (WMA) as sign of myocardial necrosis. Purpose We evaluated the ability of the assessment of regional WMA, detected via transthoracic echocardiography, to predict the presence of culprit lesions in patients presenting with acute chest pain to the emergency department. Methods In this prospective single-centre observational cohort study, we included consecutive patients presenting to the emergency department of our University Hospital with acute chest pain, suggestive of an acute coronary syndrome, between December 2018 and August 2020. Patients with ST-elevation myocardial infarction, hemodynamic instability, or known coronary artery disease were excluded. As part of initial workup, patients received bedside echocardiography for the assessment of regional WMA by a dedicated study physician, blinded to all patients' characteristics. The primary endpoint was defined as the presence of culprit lesions as detected in subsequent invasive coronary angiography, requiring coronary revascularization therapy. Logistic regression analysis was performed in different models adjusted for traditional cardiovascular risk factors, cardiac biomarkers as well as established risk scores. Area under the receiver operating characteristics curve (AUC) was calculated to assess a potential improvement in the prediction of culprit lesions. Results Overall, 657 patients (age 58.06±18.04 years, 53% male) were included in our study. WMA were detected in 76 patients (11.6%). Patients with WMA were older (66.92±13.85 vs. 56.90±18.21 years, p<0.001), had significantly higher Troponin-levels (18.5 [6.0; 91.5] vs. 6.0 [6.0; 15.0], p<0.001) and higher blood pressure (139.0±19.29 vs. ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1093/eurheartj/ehab724.1398
الإتاحة: https://doi.org/10.1093/eurheartj/ehab724.1398Test
https://academic.oup.com/eurheartj/article-pdf/42/Supplement_1/ehab724.1398/41060504/ehab724.1398.pdfTest
حقوق: https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_modelTest
رقم الانضمام: edsbas.17F4ADBB
قاعدة البيانات: BASE