PMID- 21351662
OWN - NLM
STAT- MEDLINE
DCOM- 20110317
LR  - 20110225
IS  - 0042-773X (Print)
IS  - 0042-773X (Linking)
VI  - 57
IP  - 1
DP  - 2011 Jan
TI  - [Acute heart failure and early development of left ventricular dysfunction in 
      patients with ST segment elevation acute myocardial infarction managed with 
      primary percutaneous coronary intervention].
PG  - 43-51
AB  - BACKGROUND: Acute heart failure during ST elevation myocardial infarction (STEMI) 
      makes worse prognosis. The aim of the work was to find independent factors with 
      relationship to acute heart failure (AHF) and the early development of left 
      ventricular dysfunction within the prospective followed patients with STEMI. 
      METHODS: A total of 593 patients with STEMI treated by primary PCI (164 patients 
      with AHF) were the study population. The activity of BNP and NT-ProBNP were 
      measured at hospital admission and 24 h after MI onset. Left ventricular 
      angiography was done before PCI; echocardiography was undertaken between the 
      third and fifth day after MI. RESULTS: The patients with AHF had higher level of 
      glycaemia, creatinine, uric acid, HDL-cholesterol, leukocytosis and natriuretic 
      peptid. The total hospital mortality was 3.7%. 0.2% within the patients without 
      AHF, 3.2%, 14.3%, resp. 63.6% within the patients with mild AHF, with pulmonary 
      oedema, resp. with cardiogenic shock. The patients with AHF had lower ejection 
      fraction (45.4 +/- 11.9% vs 53.0 +/- 10.3%). According to the multiple logistic 
      regression we found higher glycaemia, age, heart rate, anterior wall MI, lower 
      aortic pulse pressure and collaterals of infarct related artery as factors with 
      independent relationship to AHF. Higher glycaemia, age, heart rate, anterior wall 
      MI and lower aortic pulse pressure were found as independent factors with 
      relationship to left ventricular dysfunction. According to ROC analysis possible 
      cut off corresponding with AHF we suggested 29.5 mm Hg for LVEDP, 28.5 for 
      dP/dt/P, 9.5 mmol/l for glycaemia, 50 mm Hg for aortic pulse pressure. 
      CONCLUSIONS: Our results found the development of AHF in one third of patients 
      with STEMI. AHF increases the risk of in-hospital mortality and the risk depends 
      upon severity of failure. As the independent factors with relationship to 
      development of AHF or left ventricular dysfunction we detected higher glycaemia, 
      heart rate, anterior wall MI, age. Lower risk had patients with higher aortic 
      pulse pressure.
FAU - Parenica, J
AU  - Parenica J
AD  - Interni kardiologicka klinika Lekarske fakulty MU a FN Brno. 
      jiri.parenica@atlas.cz
FAU - Kala, P
AU  - Kala P
FAU - Jarkovsky, J
AU  - Jarkovsky J
FAU - Poloczek, M
AU  - Poloczek M
FAU - Toman, O
AU  - Toman O
FAU - Goldbergova, M Pavkova
AU  - Goldbergova MP
FAU - Manousek, J
AU  - Manousek J
FAU - Prymusova, K
AU  - Prymusova K
FAU - Kubkova, L
AU  - Kubkova L
FAU - Tesak, M
AU  - Tesak M
FAU - Elbl, L
AU  - Elbl L
FAU - Cermakova, Z
AU  - Cermakova Z
FAU - Spinar, J
AU  - Spinar J
LA  - cze
PT  - English Abstract
PT  - Journal Article
TT  - Akutni srdecni selhani a casny rozvoj dysfunkce leve komory a patientu s akutnim 
      infarktem myokardu s elevacemi ST lecenych primarni perkutanni koronarni 
      intervenci.
PL  - Czech Republic
TA  - Vnitr Lek
JT  - Vnitrni lekarstvi
JID - 0413602
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Echocardiography
MH  - *Electrocardiography
MH  - Female
MH  - Heart Failure/*etiology
MH  - Hemodynamics
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/diagnosis/physiopathology/*therapy
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Prognosis
MH  - Risk Factors
MH  - Ventricular Dysfunction, Left/*etiology
EDAT- 2011/03/01 06:00
MHDA- 2011/03/18 06:00
CRDT- 2011/03/01 06:00
PHST- 2011/03/01 06:00 [entrez]
PHST- 2011/03/01 06:00 [pubmed]
PHST- 2011/03/18 06:00 [medline]
PST - ppublish
SO  - Vnitr Lek. 2011 Jan;57(1):43-51.