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Prognostic value of mitral annular plane systolic excursion in patients with acute coronary syndrome and preserved ejection fraction.
Session:
Posters (Sessão 6 - Écran 5) - Imagem 4 - Ecocardiografia 2
Speaker:
Vanda Neto
Congress:
CPC 2022
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Vanda Devesa Neto; João Miguel Santos; Joana Laranjeira Correia; Inês Costa Silva; Inês Pires; Gonçalo Ferreira; Luis Ferreira Santos
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">Introduction:</span></span></span></strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a"> Mitral annular plane systolic excursion (MAPSE) is a quick and reliable echocardiographic tool for assessing longitudinal left ventricular (LV) systolic function. Also, MAPSE correlates with LV longitudinal strain but is less dependent on the quality of echocardiographic images. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">Aim:</span></span></span></strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a"> Identify the association between average MAPSE (aMAPSE) and 12-month mortality and hospitalizations (12MM and 12MH) in patients with ACS and preserved ejection fraction (EF). </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">Methods:</span></span></span></strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a"> Retrospective analysis of 127 patients admitted in a cardiology department with ACS and preserved ejection fraction (LV ejection fraction >40%). Echocardiography was performed in all patients, and anterior, lateral, inferior, and septal MAPSE were recorded. Then average MAPSE (aMAPSE) was calculated, and 10mm was assumed as the cut-off value for population division. Mann-Whitney U was performed for univariate analysis, and Cox-regression analysis was used to assess independent risk factors. Kaplan-Meier survival plot was used to evaluate the predictive power of aMAPSE on 12MM and 12MH. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">Results:</span></span></span></strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a"> Mean age was 63,7±14,2 years; 81% were men. 54% had diagnosis of ST-segment elevation. Mean LV ejection fraction (LVEF) was 55,1±9%, 28% had LVEF <50%. Mean wall motion score index was 1,25±0,24. Mean TAPSE was 20,2±3,8mm. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">Mean aMAPSE was 10,4±2,2mm. 37% (n=47) had aMAPSE<10mm. 12MM and 12MH were 7,5% and 15%, respectively. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">When stratified by non-reduced or reduced aMAPSE, there were significantly differences in age (60,2±14,2 vs 69,6±12,1; p<0,01), FEVE (57,2±8,3 vs 51,4±9,0; p<0,01) and global longitudinal strain (15,9±3,2 vs 11,7±3,3; p<0,01). </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">In survival analysis, aMAPSE<10mm was significantly associated with superior 12MM (10% vs 6%; p<0,01, </span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">χ</span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">2 6,8) and superior 12MH (6% vs 2%; p<0,01; </span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">χ</span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">2 8,9). </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">Cox regression analysis demonstrated that aMAPSE<10mm independently predicts 12-MH (OR: 4,7) even after adjustment for other prognostic markers, such as sex, diagnosis of ST-elevation segment elevation, and history of ischemic heart disease. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a">Conclusion:</span></span></span></strong><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#0e101a"> Previous history of aMAPSE<10mm is associated with higher 12 month-mortality and hospitalizations in patients with ACS and preserved EF. Its use may identify patients with an increased risk of re-admission and mortality, needing specialized care and a closer follow-up.</span></span></span></span></span></p>
Slides
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