Tạp chí Tim mạch học Việt Nam

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NGHIÊN CỨU LÂM SÀNG Issue: Issue 99, 2022

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Nguyễn Thị Nô En: Đại học Y Hà Nội; Lê Ngọc Anh: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Lê Ngọc Anh: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Tạ Mạnh Cường: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai;
Published: November 1, 2021
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Abstract

Objective: To determine the relationship of serum hs-Troponin I after first acute myocardial infarction with left ventricular ejection fraction by transthoracic echocardiography.
Methods: A total of 103 patients of acute myocardial infarction were included in the descriptive cross-sectional process study. Hs-Troponin I concentration was measured by ELISA method and echocardiographic ejection fraction was calculated by modified Simpson’s rule. Echocardiographic ejection fraction was compared with serum troponin I concentration. Patients with previous myocardial infarction and non-cardiac causes of troponin elevation were excluded.
Result: There was strong negative correlation between hs-troponin I concentration and left ventricular ejection fraction, with an increasing troponin level, there was a fall in ejection fraction. The Pearson’s correlation coefficient was -0,66 which was statistically significant (p=0.0007). In our study, we observed that patients with ejection fraction <50% (left ventricular systolic dysfunction) were having post-procdural cTnI levels ≥21892 ng/L. Therefore a presumptive cut off level of cTnI ≥21892 ng/L may be taken to consider left ventricular systolic dysfunction in STEMI, with the value of AUC is 0.7 and the sensitivity, the specificity of this value is: 83.7% and 52.9%, respectively.
Conclusion: There was strong negative correlation between hs-troponin I concentration and left ventricular ejection fraction in patients presenting for the first acute ST elevation myocardial infarction. Thus, Troponin I can be used as a predictive test of left ventricular systolic function (EF) measured by Simpson's rule and transthoracic echocardiography. The level of hs-Troponin I ≥ 21892 ng/L may be taken to predict the state of left ventricular dysfunction with the sensitivity of this value is 83,7% and the
specificity is 52.9%.

References

1.
1. Trường Đại học Y Hà Nội – Bộ môn Nội (2019), Bệnh học Nội khoa tập 1, nhà xuất bản Y học.
2.
2. Elliott M. Antman and al (1996). Cardiac-specific troponin i levels to predict the risk of mortality in patients with acute coronary syndromes. The New England Journal of Medecine, Volume 335, No 18, 1347
3.
3. Olga Perelshtein Brezinov and al (2017). Prognostic value of ejection fraction in patients admitted with acute coronary syndrome. Medecine, 96:9, 3.
4.
4. Katrukha (2013). Human Cardiac Troponin Complex – Structure and Functions. Biochemistry (Moscow), Vol 78, No.13, pp. 1447 – 1465.
5.
5. Vermeiren Guy, Malbrain Manu, Walpot Jeroen: Cardiac Ultrasonography in the critical care setting: A practical approach to asses cardiac function and preload for the "non-cardiologist". Anaesthesiology intensive therapy; 47, 10.5603/AIT.a2015.0074
6.
6. Salam Naser Zangana, Abdulkareem A.AL-Othman, Namir G.AL-Tawil. Role of Cardiac Troponin I level in predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction in Erbil-Iraq. Vol. 13 No. 1 (2017): Diyala Journal of Medicine the volume 13, Issue 1 for the month of October 2017.
7.
7. Zhang-Wei Chen, Zi-Qing Yu, Hong-Bo Yang et al. Rapid predictors for the occurrence of reduced left ventricular ejection fraction between LAD and non-LAD related ST-elevation myocardial infarction. BMC Cardiovascular Disorders volume 16, Article number: 3 (2016).
8.
8. M. Imteyaz Ahmad and al (2013). Cardiac Troponin I Level in STEMI and Clinical Correlation with Left Ventricular Dysfunction in Indian Population. Journal of Cardiovascular Diseases & Diagnosis, Volume 1, Issue 4, p.1000116.
9.
9. M E Hands, V Antico, P L Thompson, J Hung, J S Robinson, B L Lloyd. Differences in left ventricular function between anterior and inferior myocardial infarction of equivalent enzymatic size. Int J Cardiol 1987 Nov;17(2):155-67.
10.
10. Peter HStoneMD, FACC; Daniel SRaabeMD, FACC; Allan SJaffeMd, FACC. Prognostic significance of location and type of myocardial infarction: Independent adverse outcome associated with anterior location. Journal of the American College of Cardiology, Volume 11, Issue 3, March 1988, Pages 453-463
11.
11. H L Kennedy, R J Goldberg, M Szklo, J A Tonascia. The prognosis of anterior myocardial infarction revisited: a community-wide study. Clin Cardiol 1979 Dec;2(6):455-60.
12.
12. Tzu-Hsien Tsai, Han-Tan Chai, Cheuk-Kwan Sun, Steve Leu. Comparison of 30-day mortality between anterior-wall versus inferior-wall ST-segment elevation myocardial infarction complicated by cardiogenic shock in patients undergoing primary coronary angioplasty. Cardiology 2010;116(2):144-50.

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