INTRODUCTION

This study was conducted to determine the utility of two-dimensional speckle tracking echocardiography (2D STE) in predicting major adverse cardiac events (MACEs) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).

METHODOLOGY

This is a prospective cohort study that included 91 patients diagnosed to have NSTE-ACS. In-hospital and 6-month MACEs were evaluated in relation to their baseline echocardiographic parameters, 2D speckle strain, and strain rate analyses.

RESULTS

Among the conventional echocardiographic parameters, only left ventricular end-systolic diameter (LVESD) and wall motion scores showed significant difference between those with and without outcomes after 6 months. Significant higher wall motion scores (24.06 vs 20.91 P = 0.0320) and LVESD (3.36 vs 2.97 cm, P = 0.0125) were noted among those who had MACE after 6 months. There were no significant differences among the 2D STE strain and strain rate between those patients with and without MACE during their hospital admission. However, after 6-month follow-up, significantly lower mean left ventricular global longitudinal strain (GLS) (−14.22% ± 4.45% vs −16.44% ± 4.19%, P = 0.0261) and strain rate (−0.69 ± 0.36 s-1 vs −0.94 ± 0.25 s-1, P = 0.009) were observed among patients with MACE compared with those without. Incidence of reduced GLS strain and strain rate was significantly higher in those with MACE after 6 months. Left ventricular GLS sensitivity and specificity were 64.64% and 61.70%, respectively, at a cutoff value of less than −15.0% for detecting MACE within 6 months. Left ventricular GLS cutoff point less than −12.0%, which detects severe LV dysfunction in previous studies, have a sensitivity of 40% but a high specificity of 82.98% for predicting MACE after 6 months.

CONCLUSION

Both LV GLS strain and strain rate can be used to predict major adverse cardiovascular events after NSTE-ACS.

cardiac events ; Cardiovascular Diseases

Acute colonic ischemia is the most common form of gastrointestinal ischemia. The majority of cases of non-occlusive ischemic colitis are associated with severe congestive heart failure with low cardiac output, or disease states resulting in dehydration, or the splanchnic vasoconstrictive effect of some dedications. Reactive splanchnic vasoconstriction is responsible for nonocclusive ischemic colitis. The authors report a case of 37-year-old man, who had a history of 8-year gout and no evidence of heart disease or severe dehydration and developed segmental ischemic colitis during nonsteroidal antinflammatory drug treatment, which ultimitely progressed to transmural infacrction, therby undergone extended right hemicolectomy
Adult ; Anniversaries and Special Events ; Cardiac Output, Low ; Colitis, Ischemic* ; Colon ; Dehydration ; Gout ; Heart Diseases ; Heart Failure ; Humans ; Ischemia ; Vasoconstriction