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Exercise Echocardiography on LV Mechanics in Patients With CAD: a Speckle-tracking Echocardiography

Conditions
Cardiovascular Diseases
STEMI
NSTEMI
Interventions
Other: exercise stress echocardiography
Registration Number
NCT04824001
Lead Sponsor
China Medical University Hospital
Brief Summary

Recovering blood flow to a coronary stenosis may improve left ventricular (LV) function in patients with coronary artery disease (CAD). However, the reported data about evaluation of LV function post-percutaneous coronary intervention (PCI) in CAD was limited. The aim of this study was to compare the LV function measured by 3 min low dose exercise stress echocardiography (ESE) combined 2D speckle tracking echocardiography (STE) in patients with CAD underwent PCI, and to identify factors affecting the change of LV function. Patients with CAD who underwent acute PCI were enrolled.

Detailed Description

The assessment of temporal changes in systolic and diastolic regional left ventricle function by 2D-STE after successful reperfusion therapy of acute myocardial infarction (AMI).The estimated total number of participants is 90 patients with AMI and treated with successful percutaneous coronary intervention were included in this study. The echocardiographic measurements were performed in all patients within in-hotpital after PCI procedure, and then followed up at 7, 14, 30, 60 and 180 days after discharge. Recovery of regional systolic and diastolic myocardial function after acute myocardial infarction evaluated by ESE-STE.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
90
Inclusion Criteria
  • acute myocardial infarction diagnosed by a physician
  • undergoing percutaneous coronary intervention
  • Exercise testing and stress echocardiography are performed with the approval of the physician.
Exclusion Criteria
  • Severe cardiac valve disease
  • Left bundle branch block
  • Uncontrolled diabetes or hypertension
  • Orthopedics or other conditions that hinder from exercise
  • Uncontrolled sinus tachycardia (greater than 120 beats per minute)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
STEMIexercise stress echocardiographyST-segment elevation myocardial infarction (STEMI) is defined by symptoms of myocardial ischemia accompanied by a persistent elevation of the ST segment on the electrocardiogram (ECG) and the subsequent release of biomarkers of myocardial necrosis.
NSTEMIexercise stress echocardiographyIf there is elevation of the blood markers suggesting heart damage, but no ST elevation seen on the EKG tracing, this is known as a non ST-elevation myocardial infarction (NSTEMI).
Primary Outcome Measures
NameTimeMethod
The alterations of LV mechanics responses to a 3-min low dose exercise stress echocardiography following time.detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.

The STE was performed at rest, during exercise and recovery to compare the changes of LV machines following discharge. The standardized exercise test was conducted by 50-W semirecumbent cycling (Cardiac Stress Table w/Angio) for 3 min. Stress echocardiograph images were acquired at the third minute of cycling to ensure that subjects had reached a steady-state HR.

Secondary Outcome Measures
NameTimeMethod
The creatine kinase-MB (CK-MB) levelsdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

The CK-MB levels (picograms/milliliter) will be analysed from blood samples taken by a registered phlebotomist.

The left ventricle massdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

Measurements of LVmass and the short fraction index were automatically derived using standard equations as followed: LVmass(gm) = 0.77 X 10\^-3X \[(IVS + LVIDd +PW)\^3 - (LVIDd)\^3 + 2.4\]

The left ventricle ejection fractiondetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

LV ejection fraction (LVEF) was determined using the modified Simpson's method from the apical four-chamber views.

The brain-type natriuretic peptide (BNP) levelsdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

BNP levels (picograms/milliliter) will be analysed from blood samples taken by a registered phlebotomist.

Cardiopulmonary fitnessdetected at the day 30, 60, and 180 after discharge.

The graded exercise test (GXT) was performed with a cycle ergometer at the day 30 and 180 after discharge. The GXT comprised of unloaded pedaling for 2 min followed by a continuous increase in work rate (20-30 W) every 3 min until exhaustion (i.e., V˙ O2max). Minute ventilation (V˙ E), V˙ O2, and CO2 production (V˙ CO2) were measured breath-by-breath using a computer-based system (MasterScreen CPX; Cardinal Health Germany).

The high-sensitivity CRP (hsCRP) levelsdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

hsCRP levels (picograms/milliliter) will be analysed from blood samples taken by a registered phlebotomist.

The creatine kinase (CK) levelsdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

The CK levels (picograms/milliliter) will be analysed from blood samples taken by a registered phlebotomist.

The left ventricle wall and cavity dimensionsdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

M-mode images were used to determine the LV wall and cavity dimensions at end-systole and end-diastole from a parasternal long axis view.

The left ventricle diastolic functionsdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

Analysis of Doppler pulsed wave was performed to determine diastolic transmitral blood flow velocities for peak early (E) and late (A) fillings and was also detected the diastolic mitral annular tissue velocities for peak early (E') and late (A') fillings.

The troponin I levelsdetected at the detected at the in-hospital and the day 7, 14, 30, 60, and 180 after discharge.ay 30, 60, and 180 after discharge.

The troponin I levels (picograms/milliliter) will be analysed from blood samples taken by a registered phlebotomist.

Trial Locations

Locations (1)

Asia University Hospital

🇨🇳

Wufeng, Taichung, Taiwan

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