Selvester score and myocardial performance index in acute anterior myocardial infarction

Kaplangoray, Mustafa; Aydın, Cihan; Toprak, Kenan; Cekici, Yusuf

doi:10.1590/1806-9282.20221252

Acessibilidade / Reportar erro

Brasil

Revista da Associação Médica Brasileira

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Assoc. Med. Bras. 69 (2) • 2023 • https://doi.org/10.1590/1806-9282.20221252 copy

Selvester score and myocardial performance index in acute anterior myocardial infarction

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

BACKGROUND:

The simplified Selvester QRS score is a parameter for estimating myocardial damage in ST-elevation myocardial infarction. ST-elevation myocardial infarction leads to varying degrees of impairment in left ventricular systolic and diastolic function. Myocardial performance index is a single parameter that can predict combined left ventricular systolic and diastolic performance.

OBJECTIVE:

We investigated the relationship between Selvester score and myocardial performance index in patients undergoing primary percutaneous coronary intervention for acute anterior myocardial infarction.

METHODS:

The study included 58 patients who underwent primary percutaneous coronary intervention for acute anterior myocardial infarction. Selvester score of all patients was also calculated at 72 h. Patients were categorized into two groups according to the Selvester score. Those with a score <6 (low score) were considered group 1 and those with a score ≥6 (high score) were considered group 2.

RESULTS:

When compared with group 1, patients in group 2 were older (p=0.01) and had lower left ventricular ejection fractions (50.3±4 vs. 35.6±6.9, p=0.001), and conventional myocardial performance index (0.52±0.06 vs. 0.69±0.08, p=0.001), lateral tissue Doppler-derived myocardial performance index (0.57±0.08 vs. 0.72±0.08, p=0.001), and septal tissue Doppler-derived myocardial performance index (0.62±0.07 vs. 0.76±0.08, p=0.001) were higher. There was a high correlation between lateral tissue Doppler-derived myocardial performance index and conventional myocardial performance index and Selvester score (r=0.80, p<0.001; r=0.86, p<0.001, respectively) and a moderate correlation between septal tissue Doppler-derived myocardial performance index and Selvester score (r=0.67, p<0.001).

CONCLUSIONS:

The post-procedural Selvester score can predict lateral tissue Doppler-derived myocardial performance index and conventional myocardial performance index with high sensitivity and acceptable specificity in patients undergoing primary percutaneous coronary intervention for acute anterior myocardial infarction.

KEYWORDS:
Echocardiography; Infarction; Percutaneous coronary intervention

		Patients (n=58)
Gender (M/F), n (%)		46/12 (79.3%/20.7%)
Age (years), mean±SD		58.13±11.3
Weight (kg), mean±SD		80.2±9.8
Height (cm), mean±SD		173.13±6.6
BMI (kg/m²), mean±SD		26.7±3.5
Diabetes, n (%)		24 (41.4%)
Hypertension, n (%)		24 (41.4%)
Hyperlipidemia, n (%)		32 (55.2%)
Smoking, n (%)		28 (48.3%)
Family history of coronary artery disease (%)		14 (24.1%)
Echocardiographic measurements
	LVEF (%)	42.76±9.3
	Mitral E velocity (cm/s)	68.7±18.5
	Mitral A velocity (cm/s)	76.4±17.6
	Mitral E/A ratio	0.94±0.38
	IVRT (ms)	95.6±11.4
	IVCT (ms)	68.1±16.5
	ET (ms)	266.6±15.2
	cMPI	0.61±0.11
	Lateral IVRT (ms)	92.8±11.4
	Lateral IVCT (ms)	76.1±18.7
	Lateral ET (ms)	257.6±15.5
	Lateral tMPI	0.65±0.11
	Septal IVRT (ms)	100.2±11.2
	Septal IVCT (ms)	77.3±17.5
	Septal ET (ms)	254.3±13.6
	Septal tMPI	0.70±0.1
Electrocardiographic measurements
	STE1 (mV)	11.5±4.9
	STE2 (mV)	5.2±3.34
	72 h Selvester score	6.1±2.4
Laboratory results
	Glucose (mg/dl)	198.72±105.9
	Creatinine (mg/dl)	1.08±0.42
	Sodium (mmol/L)	140±8.5
	Hemoglobin	16.3±5
	Platelet count (×10³/μl)	294.6±71.8
	High-density lipoprotein (mg/dl)	36.5±5.6
	Low density lipoprotein (mg/dl)	133.3±28.8
	Total cholesterol (mg/dl)	216.2±39.9
	Triglycerides (mg/dl)	178.3±22.5
Medication
	Acetylsalicylic acid	30 (51.7%)
	ACE-I /AT-II blocker	26 (44.8%)
	Beta-blocker	14 (24.1%)
	Statin	12 (20.7%)

Variables	Group 1 (72 h Selvester score <6) (n=28)	Group 2 (72 h Selvester score ≥6) (n=30)	p
Age	56±12.6	60±9.8	0.01
LVEF (%)	50.3±4	35.6±6.9	<0.001
cMPI	0.52±0.06	0.69±0.08	<0.001
Lateral tMPI	0.57±0.08	0.72±0.08	<0.001
Septal tMPI	0.62±0.07	0.76±0.08	<0.001
72 h QRS duration (ms)	83±10.7	94±10.3	<0.001
STE1	10.4±5.2	12.3±4.4	0.141
STE2	3.2±1.7	6.8±3.5	<0.001

Variables	Univariate analysis		Multivariate analysis
Variables	OR (95%CI)	p	OR (95%CI)	p
Age	1.070 (1.013–1.131)	0.016	1.042 (0.943–1.153)	0.417
Septal tMPI	1.205 (1.091–1.331)	<0.001	0.99 (0.797–1.246)	0.02
Lateral tMPI	1.45 (1.191–1.765)	<0.001	1.28 (0.787–2.083)	0.04
cMPI	1.308 (1.146–1.492)	<0.001	1.198 (0.903–1.591)	0.01

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *Corresponding author: drcihanaydin@hotmail.com