P1048Does endothelial dysfunction influence left ventricular myocardium damage in young patients after acute myocardial infarction?


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Abstract

Background: Endothelial vasomotor dysfunction is an early event involved in the pathogenesis of atherosclerosis and cardiovascular events including acute coronary syndromes and consequent post-myocardial infarction heart failure. We sought to determine whether the endothelial function assessed by means of brachial artery flow-mediated dilation (FMD) correlates with selected echocardiographic parameters of left ventricular dysfunction in patients after acute myocardial infarction (AMI).Methods: The study group comprised 100 patients aged below 60 years, with first AMI treated with primary percutaneous intervention (pPCI) and stent implantation. In all patients the infarct-related artery was the only lesion. High-resolution ultrasound assessment of endothelial function by FMD as well as transthoracic echocardiography including evaluation of left ventricular ejection fraction (LVEF) and wall motion index (WMI) were performed in 3rd day and 6 months after AMI.Results: In patients included in this study the average value of LVEF in 3rd day after AMI was 55.1% (SD±8.4%), WMI- 1.35 (SD±0.38), whereas FMD was 1.35% (SD±1.2%). In 6 months follow-up after AMI, the significant improvement of LVEF, WMI and FMD was observed (p<0.001). There was no correlation between FMD and echocardiographic parameters of heart failure in 3rd day after AMI. In contrast, our results revealed significant connection between FMD and LVEF as well as FMD and WMI in 6 months follow-up. The alteration of FMD was strictly associated with improvements of LVEF (Spearman's rank correlation index=0.4, p<0.001), whereas the increased WMI correlated with poorer endothelial function (Spearman's rank correlation index= -0.38, p<0.001).Conclusions: The present study underscores the importance of endothelial dysfunction in pathogenesis of heart failure in young patients after AMI. Endothelial function assessed 6 months after AMI significantly correlates with left ventricular damage.

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