The role of diastolic dysfunction in heart failure development in patients with myocardial infarction without ST segment elevation and metabolic syndrome

Objective. The aim of this study was to assess the left ventricular diastolic dysfunction (LVDD) contribution to the development of heart failure (HF) in non-ST-segment elevation myocardial infarction (NSTEMI) patients with metabolic syndrome (MS). Design and methods. 116 consecutive NSTEMI patients were divided into groups according to the presence of MS: group I - 58 patients with MS (25 men, 33 women, mean age 62,9 ± 10,5 years), group II (control) - 58 patients without MS (31 men, 27 women, mean age 62,7 ± 11,9 years). HF was estimated based on the Killip classification. Echocardiography was performed during the first hour of the hospitalization, systolic and diastolic function were assessed. Results. Patients of group I with HF class of Killip II and more, had significantly higher diastolic filling flow velocity DT than patients with Killip I (222,84 ± 50,35 vs. 187,07 ± 39,52 ms, p = 0,03). Besides patients in group I with symptoms of HF showed higher IVRT: 113,94 ± 25,56 ms compared to 98,13 ± 18,43 ms in patients of group I without HF, p = 0,06. Comparative analysis of the diastolic function parameters between the groups showed higher DT in patients of group I in comparison with patients of group II (222,84 ± 50,35 vs. 184,36 ± 53,03 ms, p = 0,04). Left ventricular ejection fraction was reduced in patients with symptoms of HF of the both groups. Conclusions. Symptomatic HF in patients with NSTEMI against the background of MS is determined by the both diastolic and systolic function disturbances.

metabolic syndrome, diastolic dysfunction, myocardial infarction without ST segment elevation

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