Relationship between myocardial performance index and severity of coronary artery disease in patients with non-ST-segment elevation acute coronary syndrome

Cardiovasc J Afr. Jan/Feb 2017;28(1):4-7. doi: 10.5830/CVJA-2016-041.

Abstract

Objectives: We aimed to investigate the relationship between myocardial performance index (MPI) and severity of coronary artery disease, as assessed by the Gensini score (GS), in patients with non-ST-segment elevation myocardial infarction (NSTEMI).

Methods: Ninety patients with an initial diagnosis of NSTEMI were enrolled in our study. They were divided into tertiles according to the GS: low GS < 19; mid GS > 19 and ≤ 96; and high GS > 96.

Results: The low-, mid- and high-GS groups included 24, 38 and 28 patients, respectively. Clinical features such as gender distribution; body mass index (BMI); prevalence of diabetes mellitus, hypertension and hyperlipidaemia; and smoking status were similar in the three groups. MPI and isovolumic relaxation time were significantly higher in the high-GS group than in the low- and mid-GS groups (p < 0.001 and p = 0.005, respectively). Furthermore, the high-GS group had a significantly lower ejection fraction and ejection time (p = 0.01 and p < 0.001, respectively). MPI was positively correlated with the GS (r = 0.47, p < 0.001), and multivariate regression analysis showed that MPI was an independent predictor of the GS (β = 0.358, p < 0.001).

Conclusions: Patients with NSTEMI who fall within the high-risk group may be identified by means of a simple MPI measurement.

MeSH terms

  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / physiopathology*
  • Coronary Angiography
  • Coronary Vessels / diagnostic imaging*
  • Echocardiography
  • Electrocardiography*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Contraction / physiology*
  • Prospective Studies
  • Severity of Illness Index
  • Ventricular Function, Left / physiology*