Abstract
Objective: to evaluate cardiac remodeling in patients with and without COPD after the first STEMI.
Materials and Methods: group I – 87 COPD patients after the first STEMI (51-males, mean age - 55.8 ± 8.4 years): group A - in 4, group B – 14, group C – 11, group D – in 25 (GOLD, 2019). Localization of MI in the anterior descending artery was 50%. Group II – 54 patients without COPD, comparable in age, gender and location of MI. Before and during the first week after the initial PCI, all patients underwent standard EchoCG; global longitudinal strain (GLS), troponin I and the creatine phosphokinase MB (CPK MB) were evaluated.
Results: patients with and without COPD had similar LV EF (43.5 ± 1.5% vs. 49.9 ± 1.2%, p = 0.08) and MI size (cardiac troponin I peak: 7.2 [5.0–8.1] mcg/l vs. 5.9 [3.5–6.9] ng/l, p = 0.06; CPK MB peak: 825 [589-941] vs. 681 [427-869] E/l, p =0.11), whereas LV GLS was significantly more pronounced in group I (-10.4 ± 0.4% vs. -14.9 ± 0.6%, p <0.001).
After adjusting for clinical and echocardiographic characteristics, COPD was independently associated with GLS changes (β 1.54, 95% CI from 1.06 to 2.11, p <0.001). The LV mass index and LV mass were higher in group I by 11.2% (p < 0.01). RV hypertrophy and restrictive type of transtricuspid blood flow (RV wall thickness = 5.5 [4.1-6.3] mm, (E/a TV = 1.66 [0.99 - 2.4]) were also more often registered in group I. Pulmonary hypertension in COPD patients was moderate (26.7 ± 4.4 mmHg).
Conclusion: in the presence of concomitant COPD, patients after STEMI are diagnosed with more pronounced changes in intracardiac hemodynamics in both the right and left parts of the heart with moderate pulmonary hypertension.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 549.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020