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Mitral Annular Displacement by Doppler Tissue Imaging May Identify Coronary Occlusion and Predict Mortality in Patients with Non-ST-Elevation Myocardial Infarction
KTH, School of Technology and Health (STH), Medical Engineering.ORCID iD: 0000-0002-5156-2535
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2013 (English)In: Journal of the American Society of Echocardiography, ISSN 0894-7317, E-ISSN 1097-6795, Vol. 26, no 8, 875-884 p.Article in journal (Refereed) Published
Abstract [en]

Background: Mitral annular displacement (MAD) is a simple marker of left ventricular (LV) systolic function. The aim of this study was to test the hypothesis that MAD can distinguish patients with non-ST-segment elevation myocardial infarctions (NSTEMIs) from those with significant coronary artery disease without infarctions, identify coronary occlusion, and predict mortality in patients with NSTEMIs. MAD was compared with established indices of LV function. Methods: In this retrospective study, 167 patients with confirmed NSTEMIs were included at two Scandinavian centers. Forty patients with significant coronary artery disease but without myocardial infarctions were included as controls. Doppler tissue imaging was performed at the mitral level of the left ventricle in the three apical planes, and velocities were integrated over time to acquire MAD. LV ejection fraction, global longitudinal strain (GLS), and wall motion score index were assessed according to guidelines. Results: MAD and GLS could accurately distinguish patients with NSTEMIs from controls. During 48.6 +/- 12.1 months of follow-up, 22 of 167 died(13%). MAD, LV ejection fraction, and GLS were reduced and wall motion score index was increased among those who died compared with those who survived (P<.001, P<.001, P<.001, and P=.02, respectively). Multivariate Cox proportional-hazards analyses revealed that MAD was an independent predictor of death (hazard ratio, 1.36; 95% confidence interval, 1.07-1.73; P=.01). MAD and GLS were reduced and wall motion score index was increased in patients with coronary artery occlusion compared with those without occlusion (P=.006, P=.001, and P=.02), while LV ejection fraction did not differ (P=.20). Conclusions: MAD accurately identified patients with NSTEMIs, predicted mortality, and identified coronary occlusion in patients with NSTEMIs.

Place, publisher, year, edition, pages
2013. Vol. 26, no 8, 875-884 p.
Keyword [en]
Myocardial infarction, Mortality, Echocardiography
National Category
Medical Engineering
Identifiers
URN: urn:nbn:se:kth:diva-127488DOI: 10.1016/j.echo.2013.05.011ISI: 000322627500013Scopus ID: 2-s2.0-84880953435OAI: oai:DiVA.org:kth-127488DiVA: diva2:644878
Note

QC 20130902

Available from: 2013-09-02 Created: 2013-08-30 Last updated: 2017-12-06Bibliographically approved
In thesis
1. The Cardiac State Diagram: A new method for assessing cardiac mechanics
Open this publication in new window or tab >>The Cardiac State Diagram: A new method for assessing cardiac mechanics
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2015. 107 p.
Series
TRITA-STH, 2015:2
Keyword
Cardiac State Diagram, Heart, Hydraulic, Mechanics, DAPP, DeltaV, Hydraulic forces, left ventricular, diastole
National Category
Engineering and Technology
Research subject
Applied Medical Technology
Identifiers
urn:nbn:se:kth:diva-202743 (URN)978-91-7595-477-6 (ISBN)
Public defence
2015-04-27, 3-221, Alfred Nobels Alle10, Huddinge, 15:57 (Swedish)
Opponent
Supervisors
Note

QC 20170306

Available from: 2017-03-06 Created: 2017-03-04 Last updated: 2017-03-06Bibliographically approved

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