Gender features of structural and functional changes of the heart and levels of copeptin and NTproBNP in patients with acute Q-myocardial infarction in the presence of pulmonary hypertension
Keywords:myocardial infarction, pulmonary hypertension, gender features
The aim. To evaluate the gender features of structural and functional changes in the heart and levels of copeptin and NTproBNP in patients with acute myocardial infarction (AMI) with concomitant pulmonary hypertension (PH).
Materials and methods. 74 patients with AMI and concomitant PH who were treated in the intensive care unit and emergency cardiology for patients with myocardial infarction of the Municipal Non-Profit Enterprise “City Hospital of Emergency and Ambulance” of Zaporizhzhia City Council were examined. The patients were divided into two groups: the first group consisted of 42 male patients (mean age 71.06 ± 2.21 years) and 32 female patients (mean age 76.41 ± 2.32 years). All the patients were examined in the first three days by two-dimensional echocardiography on a device MyLab50 (“Esaote”, Italy). The serum levels of kopeptin and NTproBNP were determined by enzyme-linked immunosorbent assay using a set of reagents Elabscience (USA).
Results. There was a trend towards a predominantly anterior AMI in the group of men and lower AMI – in the group of women. Individuals with functional class III and IV heart failure predominated (76.1 %) among the men with AMI and PH. At the same time, there were significantly more persons with III and IV functional class in the group of men than in the group of women (P < 0.05). There was a significant diastolic left ventricular posterior wall thickening in women compared to men (8.4 %; P < 0.05) and a tendency to diastolic interventricular septal thickening in females. There was an upward trend in end-systolic and end-diastolic sizes in the group of men compared to women; however, the differences did not reach the required level of significance. Evaluation of serum copeptin and NTproBNP in patients with AMI and PH revealed significantly higher levels of these indicators in the group of men compared to women (P < 0.05).
Conclusions. Men with AMI and PH had more severe heart failure compared to women due to the predominance of patients with functional classes III and IV. Women with AMI and PH demonstrated predominantly concentric type of remodeling in the form of significantly thickened LV posterior wall and the tendency to increase interventricular septum wall thickness, and eccentric hypertrophy in the form of LV dilatation prevailed in men. Men with AMI and PH had significantly higher serum copeptin and NTproBNP levels compared to women.
Kovalenko, V. M., & Dorogoi, A. P. (2016). Sertsevo-sudynni khvoroby: medyko-sotsialne znachennia ta stratehiia rozvytku kardiolohii v Ukraini [Cardiovascular disease: medical and social value and strategy of cardiology in Ukraine]. Ukrainskyi kardiolohichnyi zhurnal, (Suppl. 3), 5-14. [in Ukrainian].
Galiè, N., Humbert, M., Vachiery, J. L., Gibbs, S., Lang, I., Torbicki, A., Simonneau, G., Peacock, A., Vonk Noordegraaf, A., Beghetti, M., Ghofrani, A., Gomez Sanchez, M. A., Hansmann, G., Klepetko, W., Lancellotti, P., Matucci, M., McDonagh, T., Pierard, L. A., Trindade, P. T., Zompatori, M., … ESC Scientific Document Group. (2016). 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). European Heart Journal, 37(1), 67-119. https://doi.org/10.1093/eurheartj/ehv317
Ahsan, S., Hamed, S., Dehkordi, H., Wen, Y., Lee, S., Gholitabar, F., Bhinder, J., & Lanier, G. (2018). The impact of pulmonary hypertension on in-hospital outcomes of non-st elevation myocardial infarction. Journal of the American College of Cardiology, 71(11), A1940. https://doi.org/10.1016/s0735-1097(18)32481-1
Mehra, P., Mehta, V., Sukhija, R., Sinha, A. K., Gupta, M., Girish, M. P., & Aronow, W. S. (2019). Pulmonary hypertension in left heart disease. Archives of Medical Science, 15(1), 262-273. https://doi.org/10.5114/aoms.2017.68938
Boeddinghaus, J., Reichlin, T., Nestelberger, T., Twerenbold, R., Meili, Y., Wildi, K., Hillinger, P., Giménez, M. R., Cupa, J., Schumacher, L., Schubera, M., Badertscher, P., Corbière, S., Grimm, K., Puelacher, C., Sabti, Z., Widmer, D. F., Schaerli, N., Kozhuharov, N., Shrestha, S., … Mueller, C. (2017). Early diagnosis of acute myocardial infarction in patients with mild elevations of cardiac troponin. Clinical Research in Cardiology, 106(6), 457-467. https://doi.org/10.1007/s00392-016-1075-9
Smaradottir, M. I., Ritsinger, V., Gyberg, V., Norhammar, A., Näsman, P., & Mellbin, L. G. (2017). Copeptin in patients with acute myocardial infarction and newly detected glucose abnormalities - A marker of increased stress susceptibility? A report from the Glucose in Acute Myocardial Infarction cohort. Diabetes and Vascular Disease Research, 14(2), 69-76. https://doi.org/10.1177/1479164116664490
Lang, R. M., Badano, L. P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., Flachskampf, F. A., Foster, E., Goldstein, S. A., Kuznetsova, T., Lancellotti, P., Muraru, D., Picard, M. H., Rietzschel, E. R., Rudski, L., Spencer, K. T., Tsang, W., & Voigt, J. U. (2015). Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 28(1), 1-39.e14. https://doi.org/10.1016/j.echo.2014.10.003
Nagueh, S. F., Smiseth, O. A., Appleton, C. P., Byrd, B. F., 3rd, Dokainish, H., Edvardsen, T., Flachskampf, F. A., Gillebert, T. C., Klein, A. L., Lancellotti, P., Marino, P., Oh, J. K., Popescu, B. A., & Waggoner, A. D. (2016). Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 29(4), 277-314. https://doi.org/10.1016/j.echo.2016.01.011
Kravchun, P. P. (2015). Henderni ta vikovi osoblyvosti remodeliuvannia sertsia u khvorykh iz postinfarktnym kardiosklerozom, tsukrovym diabetom 2-ho typu ta ozhyrinniam [Gender and age characteristics of cardiac remodeling in patients with postinfarction cardiosclerosis, diabetes mellitus type 2 and obesity]. Mizhnarodnyi endokrynolohichnyi zhurnal, (2), 20-24. [in Ukrainian].
Nickel, N. P., Lichtinghagen, R., Golpon, H., Olsson, K. M., Brand, K., Welte, T., & Hoeper, M. M. (2013). Circulating levels of copeptin predict outcome in patients with pulmonary arterial hypertension. Respiratory Research, 14(1), Article 130. https://doi.org/10.1186/1465-9921-14-130
Kyselov, S. M. (2015). Henderni osoblyvosti i prohnostychne znachennia systemy matryksnykh metaloproteinaz ta yikh inhibitoriv u khvorykh na hostryi Q-infarkt miokarda livoho shlunochka [Gender peculiarities and prognostic value of matrix metalloproteinase and their inhibitors system in patients with acute Q-wave left ventricle myocardial infarction]. Zaporozhye medical journal, (1), 9-13. [in Ukrainian].
Guazzi, M., & Borlaug, B. A. (2012). Pulmonary Hypertension Due to Left Heart Disease. Circulation, 126(8), 975-990. https://doi.org/10.1161/CIRCULATIONAHA.111.085761
Marques, S. J., Luz-Rodrigues, H., David, C., Almeida, A. G., & Nunes Diogo, A. (2012). Biomarcadores da classe funcional na insuficiência cardíaca sistólica. Relevância da copeptina. Revista portuguesa de cardiologia, 31(11), 701-710. https://doi.org/10.1016/j.repc.2012.09.001
Vetrone, F., Santarelli, S., Russo, V., Lalle, I., De Berardinis, B., Magrini, L., Di Stasio, E., Salerno, G., Cardelli, P., Piccoli, A., Codognotto, M., Mion, M. M., Plebani, M., Vettore, G., Castello, L. M., Avanzi, G. C., & Di Somma, S. (2014). Copeptin decrease from admission to discharge has favorable prognostic value for 90-day events in patients admitted with dyspnea. Clinical Chemistry and Laboratory Medicine, 52(10), 1457-1464. https://doi.org/10.1515/cclm-2014-0207
Drozdova, I. V. (2017). Osoblyvosti strukturno-funktsionalnoho stanu sertsia u khvorykh na khronichnu sertsevu nedostatnist, komorbidnu z arterialnoiu hipertenziieiu [Features of structural and functional state of the heart in patients with chronic heart failure with comorbid hypertension]. Zaporozhye medical journal, 19(3), 257-260. https://doi.org/10.14739/2310-1210.2017.3.100575 [in Ukrainian].
How to Cite
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)