Combined Evaluation Of Early Changes Of STEMI Cardiac Function By Echocardiography And Plasma Levels Of N-terminal Pro-brain Natriuretic Peptide

Objective: The aim of this study was to investigate the change of cardiacfunction in STEMI patients and the correlated factors of myocardial infarction,and topredict near-term future of cardiac function.Methods: A total of220STEMI patients(163males and57females) aged39-86years were recruited for the study. We measured left ventricular ejection fraction,leftventricular diameter,left atrium diameter,and plasma levels of NT-proBNP and cTnIat different time points after the onset. Moreover,we investigated the change ofcardiac function in the peri-reperfusion period by using repeated measuresANOVA.In addition,we compared the difference between anterior and inferiormyocardial infarction in the PCI group,and compared the difference betweenpulmonary hypertension group and control group.Results:1.Left atrium diameter increased at the beginning of24h in PCIgroup;however,there was no significant difference at48h and72h.Left atriumdiameter increased to the maximum at7d,but decrease to after30d which levelshowed no difference with the level of12h (p〉0.05). Left ventricular diameterincreased at the beginning of12h,but there was no significant difference at24h and48h.After increased to the maximum at7d,Left venrticular diameter decreased,andthe level of Left ventricular at30d was similar to that at12h (p〉0.05).Leftventricular ejection fraction decreased at the beginning of12h,and reached theminimum at24h.Left ventricular ejection fraction restored original level at48h,andgradually increased during72h,7d and30d.Meanwhile,although NT-proBNP keptincreasing during72h,it significantly decreased at7d (p﹤0.05),and it futher decreased at30d. cTnI increased to the maximun at the beginning of12h,butdecreased after12h,and reached to normal levels at30g.2,There were differences inleft atrium diameter,left ventricular diameter and left ventricular ejection fractionbetween PCI group and non-PCI group.And the change trends of them were different.There were differences in NT-proBNP between PCI group and non-PCI group.Butthe change trends of NT-proBNP were similar.The change trends of cTnI weredifferent.3.There was difference only in left ventricular diameter change trendbetween anterior and inferior myocardial infarctin groups. There were differences inleft ventricular diameter and left ventricular ejection fraction and NT-proBNP atdifferent time points between the above groups.4. NT-proBNP in follow-up of onemonth in pulmonary hypertension group is higher than that of cntrol group(2555.7vs1013.7, P <0.05),and left ventricular ejection fraction is lower than that ofcontrol group(51.7vs57.1, P <0.05).Conclusion: The STEMI patients treated with PCI within12hours whose leftventricular systolic function become the worst feasibility at24h,but it was improvedafterwards.And there was on difference of change trends between anterior andinferior myocardial infarction group.Left ventricular and left atrium diameterincreased gradually,but the size of them decreased at one month follow-up.Theevaluation to cardiac function of change trends of NT-proBNP is consistent with it ofechocardiography in the peri-reperfusion period. The pulmonary hypertension ofSTEMI patients in peri-reperfusion period could suggest the progonosis of cardiacfunction.