Experimental Study Of Dual-source CT Combined With Novel Serum Biomarkers In The Assessment Of Acute Myocardial Infarction

DUAL-SOURCE CT FOR ASSESSING LEFT VENTRICULAR STRUCTURE AND GLOBAL FUNCTION IN A PORCINE MODEL OF MYOCARDIAL INFARCTION:A PILOT STUDYObjective: To validate the feasibility of third-generation DSCT for providing basic data and references of the dynamic changes in LV structural and global functional characteristics in a porcine model of acute myocardial infarction(AMI).Methods: Balloon-mediated permanent occlusion of the distal third of the left anterior descending artery was used to induce AMI in Diannan small-eared pigs.Third-generation DSCT was performed to observe dynamic changes in LV structure and function before and after AMI induction over 30 days.Results: ?The baseline interventricular septum thickness,LV anterior wall thickness,LV posterior wall thickness,LV end-diastolic dimension,and LV end-systolic dimension were 8.50±0.90 mm,8.40±1.30 mm,7.80±1.20 mm,45.00±4.90 mm,and 25.90±4.10 mm,respectively,while the baseline LV end-diastolic volume(LVEDV),LV end-systolic volume(LVESV),LV ejection fraction(LVEF),LV mass,stroke volume (SV),and cardiac output(CO)were 74.62±13.54ml,23.06±7.46 ml,69.29±6.83%,86.35±14.02g,51.56±9.77ml,and 4.22±2.14l/min,respectively.?Trends of time-dependent changes were observed for LVESV,LVEF,SV and CO(p<0.05),but nor for LVEDV or LV mass(p>0.05).Conclusion: Third-generation DSCT was a validated tool for assessing LV structure and cardiac global functional parameters in a porcine model of AMI and serve as a reference in future studies.ASSOCIATION BETWEEN SERUM COPEPTIN,IMA,NT-PROBNP LEVELS AND GLOBAL LEFT VENTRICULAR FUNCTION IN SWINE ACURE MYOCARDIAL INFARCTION MODELObjective: To determine the exact time course of changes in serum copeptin,IMA and NT-proBNP levels and to investigate the correlation between serum copeptin,IMA,NT-proBNP and global left ventricular(LV)function in a pig AMI model.Methods: Balloon mediated permanent occlusion of the left anterior descending artery was used to induce AMI in Diannan small-eared pigs.The dynamic changes of the global LV function before and within 30 days after AMI induction were evaluated by third generation of dual-source computed tomography(DSCT),and serum copeptin,IMA and NT-pro BNP levels were measured at the same time points.The correlation between serum copeptin,IMA and NT-pro BNP levels and the global LV function parameters was evaluated.Results: Serum copeptin,IMA and NT-proBNP concentrations were significantly increased at 1 h.Serum copeptin level peaked at 3h,gradually decreased after 6h of AMI induction,and returned to the baseline after 3day of AMI.Serum IMA level peaked at 6 to 12 hours,declined gradually after 12 hours,and returned to baseline 30 days later.Serum NT-pro BNP level reached the peak at 1 to 3 hours,reduced frome 3 to 6 hours,and returned gradually to the baseline level after 12 hours.Serum copeptin levels at 3h were negatively correlated with major LV functions such as LV ejection fraction(LVEF)and stroke volume(SV)at 3h and 30 day of AMI(p<0.05),but were positively correlated with 3 h and 30 day LV end-systolic volume(LVESV)(p<0.05).There was no significant correlation between 3 day serum copeptin concentration and 3 and 30 day global LV function(p>0.05).Serum IMA levels at 1?12 hs was negatively correlated with LVEF,SV and CO at all time points(p<0.05).Serum NT-pro BNP levels at 1?3 hs was negatively correlated with LVEF,SV and CO at all time points(p<0.05).Over time,when the optimal detection time windows of copeptin,IMA and NT-pro BNP in serum were exceeded,there was no significant correlation between the above serum biomarkers concentration and the global LV function(p>0.05).Conclusion: Serum copeptin,IMA and NT-pro BNP levels are were significantly correlated with the global LV function at an early stage of AMI,supporting a notion that serum copeptin,IMA and NT-pro BNP levels may serve as a biomarker for predicting outcomes of AMI patients in clinic.THE VALUR OF LEFT VENTRICULAR EJECTION COMBINED WITH SERUM COPEPTIN,IMAAND NT-PROBNP IN PREDICTING ACUTE MYOCARDIAL INFARCTION: A PILOT STUDYObjective: To investigate the value of LVEF combined with serum copeptin,IMA and NT-pro BNP levels in predicting acute myocardial infarction(AMI)of swines model.Methods: Balloon mediated permanent occlusion of the left anterior descending artery was used to induce AMI in Diannan small-eared pigs.The dynamic changes of the LVEF before and within 30 days after AMI induction were evaluated by third generation of dual-source computed tomography(DSCT),and to investigate the value of LVEF combined with serum copeptin,IMA and NT-pro BNP levels in predicting AMI.Results :(1)The change of LVEF was very significant within 1 hour after AMI induction,and the low peak occurred 6 hours after infarction,and then gradually recovered,but the value did not return to the preoperative baseline level.(2)1 hour after AMI induction,the sensitivity and specificity of LVEF predicted AMI were 83.3 % and 75.0 %(AUC:0.847;95 %CI,0.694?1.000,p<0.001).6?12 h after AMI,the sensitivity and specificity of LVEF predicted AMI were 100 %(AUC: 1.000;95 %CI,0.000?1.000,p<0.001).30 days after AMI,the sensitivity and specificity of LVEF predicted AMI were 92% and 100%(AUC: 0.986;95%CI,0.950?1.000,p<0.001).(3)1 hour after AMI induction,the specificity of LVEF combined with copeptin predicted AMI increased from 75 % to 100 %(AUC: 0.868;95 %CI,0.707?1.000,p<0.001).The sensitivity and specificity of LVEF combination with IMA predicted AMI increased from75 % to 100 % and 58.3% to 83.3%,respectively(AUC: 0.965;95 %CI,0.903?1.000,p<0.001).Conclusion: Early combination of LVEF,copeptin and IMA can improve the accuracy of new cardiac serum biomarkers in AMI prediction,and further provide some scientific basis for the combined application of imaging and new cardiac serum biomarkers in AMI diagnosis and evaluation.