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The Impact of Sonothrombolysis on Left Ventricular Diastolic Function and Left Atrial Mechanics Preventing Left Atrial Remodeling in Patients With ST Elevation Acute Myocardial Infarction

Chiang, Hsu Po ; Aguiar, Miguel O.D. ; Tavares, Bruno G. ; Rosa, Vitor E.E. ; Gomes, Sergio Barros ; Oliveira, Mucio T. ; Soeiro, Alexandre ; Nicolau, Jose C. ; Ribeiro, Henrique B. ; Sbano, João C. ; Rochitte, Carlos E. ; Filho, Roberto Kalil ; Ramires, Jose A.F. ; Porter, Thomas R. ; Mathias, Wilson ; Tsutsui, Jeane M.

Journal of the American Society of Echocardiography, 2023-05, Vol.36 (5), p.504-513 [Periódico revisado por pares]

United States: Elsevier Inc

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Título:
The Impact of Sonothrombolysis on Left Ventricular Diastolic Function and Left Atrial Mechanics Preventing Left Atrial Remodeling in Patients With ST Elevation Acute Myocardial Infarction
Autor: Chiang, Hsu Po ; Aguiar, Miguel O.D. ; Tavares, Bruno G. ; Rosa, Vitor E.E. ; Gomes, Sergio Barros ; Oliveira, Mucio T. ; Soeiro, Alexandre ; Nicolau, Jose C. ; Ribeiro, Henrique B. ; Sbano, João C. ; Rochitte, Carlos E. ; Filho, Roberto Kalil ; Ramires, Jose A.F. ; Porter, Thomas R. ; Mathias, Wilson ; Tsutsui, Jeane M.
Assuntos: Acute myocardial infarction ; Atrial Fibrillation ; Atrial Remodeling ; Female ; Heart Atria - diagnostic imaging ; Humans ; Left atrial remodeling ; Left atrial strain ; Left ventricular diastolic dysfunction ; Male ; Percutaneous Coronary Intervention - methods ; Sonothrombolysis ; ST Elevation Myocardial Infarction - diagnosis ; ST Elevation Myocardial Infarction - therapy ; Ventricular Function, Left ; Ventricular Remodeling
É parte de: Journal of the American Society of Echocardiography, 2023-05, Vol.36 (5), p.504-513
Notas: ObjectType-Article-1
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Descrição: The diagnostic ultrasound-guided high mechanical index impulses during an intravenous microbubble infusion (sonothrombolysis) improve myocardial perfusion in acute ST segment elevation myocardial infarction, but its effect on left ventricular diastolic dysfunction (DD), left atrial (LA) mechanics and remodeling is unknown. We assessed the effect of sonothrombolysis on DD grade and LA mechanics. One hundred patients (59 ± 10 years; 34% women) were randomized to receive either high mechanical index impulses plus percutaneous coronary intervention (PCI) (therapy group) or PCI only (control group) (n = 50 in each group). Diastolic dysfunction grade and LA mechanics were assessed immediately before and after PCI and at 48 to 72 hours, 1 month, and 6 months of follow-up. Diastolic dysfunction grades were classified as grades I, II, and III. The LA mechanics was obtained by two-dimensional speckle-tracking echocardiography–derived global longitudinal strain (GLS). As follow-up time progressed, increased DD grade was observed more frequently in the control group than in the therapy group at 1 month and 6 months of follow-up (all P < .05). The LA-GLS values were incrementally higher in the therapy group when compared with the control group at 48 to 72 hours, 24.0% ± 7.3% in the therapy group versus 19.6% ± 7.2% in the control group, P = .005; at 1 month, 25.3% ± 6.3% in the therapy group versus 21.5% ± 8.3% in the control group, P = .020; and at 6 months, 26.2% ± 8.7% in the therapy group versus 21.6% ± 8.5% in the control group, P = .015. The therapy group was less likely to experience LA remodeling (odds ratio, 2.91 [1.10-7.73]; P = .03). LA-GLS was the sole predictor of LA remodeling (odds ratio, 0.79 [0.67-0.94]; P = .006). Sonothrombolysis is associated with better DD grade and LA mechanics, reducing LA remodeling. •Sonothrombolysis is a new therapy in STEMI.•Sonothrombolysis improved diastolic function and LA strain in STEMI.•Sonothrombolysis reduced LA remodeling in STEMI.•Worse values of LA strain predicted LA remodeling.
Editor: United States: Elsevier Inc
Idioma: Inglês

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The Impact of Sonothrombolysis on Left Ventricular Diastolic Function and Left Atrial Mechanics Preventing Left Atrial Remodeling in Patients With ST Elevation Acute Myocardial Infarction

United States: Elsevier Inc

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