LEFT VENTRICULAR FILLING PRESSURE ASSESSED BY ECHOCARDIOGRAPHY AS A PREDICTOR OF MAYOR CARDIOVASCULAR EVENTS DURING HOSPITALIZATION IN NON ST ELEVATION MYOCARDIAL INFARCTION

Abstract

Background : Acute myocardial infarction (AMI) was marked by regional myocardial damage that caused systolic and diastolic dysfunction, relaxation time starts to shorten with a simultaneous rise in left ventricular filling pressure (LVFP). LVFP could be obtained from echocardiographic examination and would predict adverse outcome after an AMI.

Methods: Patients were collected from December 2018 until June 2019. A cohort prospective study of 110 consecutive NSTEMI patients admitted to the emergency department was studied. Variables such as previous comorbidities, medication history, ejection fractions (EF), and laboratory findings were evaluated. Echocardiographic examination was performed within 12 hours of admission in all patients. Elevated LVFP was defined as grade II and III diastolic dysfunction. The MACE component that included in this study are mortality, heart failure, arrhytmia and cardiogenic shock. They were then further followed up. The patient who underwent MACE within hospitalization start from a day of admission was then considered positive.

Result: From total 110 patients, there were 45 (40.9%) patients who underwent MACE and heart failure was the most about 42(38.2%). There were no significant risk factor difference between both groups. From chi square analysis, there was significant statistic between LVFP and in hospital MACE (RR: 3.33, 95% CI: 1.78-6.23, p value : <0.001). We then performed logistic regression between factor that could influenced in hospital MACE with the results of statistically significant of LVFP (OR: 5.40, 95% CI: 1.79-16.28; p=0.003). Conclusions: LVFP is a independent predictor of in hospital MACE in NSTEMI patients. Further prospective study in validating its predicting value was needed.