Feasibility and prognostic significance of ventricular–arterial coupling after myocardial infarction: the RIGID-MI cohort - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue European Heart Journal - Cardiovascular Imaging Année : 2023

Feasibility and prognostic significance of ventricular–arterial coupling after myocardial infarction: the RIGID-MI cohort

Samy Aghezzaf
Augustin Coisne
Christophe Bauters
Francesco Favata
  • Fonction : Auteur
Pascal Delsart
Amandine Coppin
Claire Seunes
  • Fonction : Auteur
Guillaume Schurtz
Basile Verdier
  • Fonction : Auteur
Nicolas Lamblin
Amine Tazibet
  • Fonction : Auteur
Sandro Ninni
Erwan Donal
David Montaigne

Résumé

Abstract Aims The clinical significance and feasibility of the recently described non-invasive parameters exploring ventricular–arterial coupling (VAC) remain uncertain. This study aimed to assess VAC parameters for prognostic stratification in stable patients with left ventricular ejection fraction (LVEF) ≥40% following myocardial infarction (MI). Methods and results Between 2018 and 2021, patients with LVEF ≥40% were evaluated 1 month following MI using transthoracic echocardiography (TTE) and arterial tonometry at rest and after a handgrip test. VAC was studied via the ratio between arterial elastance (Ea) and end-systolic LV elastance (Ees) and between pulse wave velocity (PWV) and global longitudinal strain (GLS). Patients were followed for major adverse cardiovascular events (MACE): all-cause death, acute heart failure, stroke, AMI, and urgent cardiovascular hospitalization. Among the 374 patients included, Ea/Ees and PWV/GLS were obtained at rest for 354 (95%) and 253 patients (68%), respectively. Isometric exercise was workable in 335 patients (85%). During a median follow-up of 32 months (interquartile range: 16–42), 41 (11%) MACE occurred. Patients presenting MACE were significantly older and had a higher prevalence of peripheral arterial disease, lower GLS, higher Ea, PWV, and PWV/GLS ratio. The Ea/Ees ratio and standard TTE parameters during isometric exercise were not associated with MACE. After adjustment, the PWV/GLS ratio was the only VAC parameter independently associated with outcome. Receiver operating characteristic curve analysis identified a PWV/GLS ratio >0.70 (Youden’s index = 0.37) as the best threshold to identify patients developing MACE: hazard ratio (95% confidence interval) = 2.2 (1.14–4.27), P = 0.02. Conclusion The PWV/GLS ratio, assessed 1 month after MI, identifies a group of patients at higher risk of MACE providing additional value on top of conventional non-invasive parameters.
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hal-04464617 , version 1 (18-02-2024)

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Samy Aghezzaf, Augustin Coisne, Christophe Bauters, Francesco Favata, Pascal Delsart, et al.. Feasibility and prognostic significance of ventricular–arterial coupling after myocardial infarction: the RIGID-MI cohort. European Heart Journal - Cardiovascular Imaging, 2023, ⟨10.1093/ehjci/jead342⟩. ⟨hal-04464617⟩
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