Chimed, Surenjav

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Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI
(Mongolian National University of Medical Sciences, 2017-06-25)
Khuyag, Batmyagmar
;
Chimed, Surenjav
;
Baldanndorj, Amarjargal
;
Zundui, Lkhagvasuren
;
Davaakhuu, Narantuya
Objectives: Left ventricular (LV) systolic function is major predictor of outcome after acute myocardial infarction (AMI). In recent years, speckle-tracking echocardiography (STE) derived strain measurement has been demonstrated to directly reflect myocardial deformation patterns and to be superior to conventional echocardiographic measurements. Our study aimed to reveal the prognostic value of strain parameters for 30-day mortality in patients with ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). Methods: We prospectively included patients with STEMI after primary PCI treatment. The primary endpoint was 30-day mortality. 2D STE was used to determine LV strain parameters. Results: 414 patients were selected. 30-day mortality occurred in 15 patients (3.6%). LV global longitudinal strain (GLS) was significantly impaired in the 30-day mortality group compared with survivors (-8.0±2.6% vs. -15.4±3.8%, p<0.001). Multivariate regression revealed that LV GLS was independently associated with 30-day mortality (OR 1.71, 95% CI 1.23-2.38, p<0.001). Adding GLS into the clinical and echocardiographic model improved model performance. Conclusion:The LV GLS parameter is an independent predictor of 30-day mortality in patients with STEMI after primary PCI treatment. Adding LV GLS into the prediction model improved its predictive performance.
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Prognostic Relevance of Intra-aortic Balloon Pump in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock: Nationwide Population Study in Taiwan
(Mongolian National University of Medical Sciences, 2016-06-25)
Chimed, Surenjav
;
Khuyag, Batmyagmar
Objectives: Intra-aortic balloon pump (IABP) is the most widely-used form of mechanical hemodynamic support in patients with cardiogenic shock. However, usefulness of IABP in the high-risk patient population is conflicting. We examined whether the patient prognosis in Taiwan forthose treated with IABP has improved in recent years. Methods: We used Taiwan's National Health Insurance Research Database to retrospectively review 3145 (2358 men, 75% of cases) cardiogenic shock patients who were treated with primary percutaneous coronary intervention (PCI) due to acute myocardial infarction (AMI) between 2000 and 2012. The primary outcome was all-cause mortality and secondary outcome was heart failure. Results: A total of 1417 patients who received IABP therapy and 1728 patients who did not receive non-IABP were selected in this study. During the follow-up period, the adjusted hazard ratio for overall mortality was 1.22 (Cl 95%: 1.10-1.35, p<0.0001) and for overall heart failure was 1.24 (Cl 95%: 1.08-1.41, p <0.001). Risk factors for all-cause mortality were previous heart failure, diabetes, chronic kidney disease and hypertension. Conclusion: In this nationwide, population-based, retrospective cohort study in Taiwan, we found that mortality rate and heart failure rate did not decline in cardiogenic shock patients who underwent primary PCI plus IABP therapy.
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Relationship Between Left Ventricular Myocardial Longitudinal Mechanics and In-hospital Heart Failure in Patients With Acute Myocardial Infarction: a Two-dimensional Speckle-tracking Study
(Mongolian National University of Medical Sciences, 2016-11-25)
Khuyag, Batmyagmar
;
Chimed, Surenjav
;
Baldandorj, Amarjargal
;
Zundui, Lkhagvasuren
;
Davaakhuu, Narantuya
Objectives: In-hospital heart failure (HF) during acute myocardial infarction (AMI) is associated with adverse outcome. However, data about the relationship between left ventricular (LV) longitudinal myocardial mechanics and in-hospital HF in patients with AMI is limited. Thus, we aimed to determine the association between speckle-tracking derived global longitudinal strain (GLS) and in-hospital HF. Methods: We selected patients with AMI treated by primary percutaneous coronary intervention (PCI). In-hospital HF was defined by Killip class. Multiple logistic regression analysis was used to reveal the relationship between LV GLS and in-hospital HF. Results: A total of 414 patients (mean age 60 ±13 years, 84% male) were included and in-hospital HF presented in 93 patients (22.5%). LV GLS was significantly impaired in patients with in-hospital HF compared to patients without (-16.1 ±3.7% vs. -11.6 ±3.1%, p<0.001). After adjustment of possible predictors, GLS was independently associated with in-hospital HF (odds ratio 1.32, 95% CI: 1.16-1.50, p<0.001). In-hospital HF presented in 21 patients with preserved left ventricular ejection fraction (LVEF) and GLS was also significantly impaired (-17.7 ±3.2% vs. -12.7 ±2.2%, p<0.001). Separate multiple logistic regression models showed that GLS was still independently associated with in-hospital HF in this group. Conclusion: LV GLS is independently associated with in-hospital HF during AMI. This relationship is still evident for patients with preserved LVEF.

Chimed, Surenjav

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