Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapy

Aim. To study parameters of left ventricular (LV) strain and heart rate variability (HRV) in patients with ST-segment elevation myocardial infarction (STEMI) in various variants of postinfarction receiving high-dose atorvastatin therapy.Material and methods. The study included 96 patients with STEMI...

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Main Authors: V. E. Oleinikov, A. V. Golubeva, Yu. A. Barmenkova, A. V. Kulyutsin, N. V. Burko, M. V. Lukyanova, N. A. Donetskaya
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2023-01-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/5078
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author V. E. Oleinikov
A. V. Golubeva
Yu. A. Barmenkova
A. V. Kulyutsin
N. V. Burko
M. V. Lukyanova
N. A. Donetskaya
author_facet V. E. Oleinikov
A. V. Golubeva
Yu. A. Barmenkova
A. V. Kulyutsin
N. V. Burko
M. V. Lukyanova
N. A. Donetskaya
author_sort V. E. Oleinikov
collection DOAJ
description Aim. To study parameters of left ventricular (LV) strain and heart rate variability (HRV) in patients with ST-segment elevation myocardial infarction (STEMI) in various variants of postinfarction receiving high-dose atorvastatin therapy.Material and methods. The study included 96 patients with STEMI. All patients underwent two-dimensional speckle tracking echocardiography and 24-hour electrocardiographic monitoring with HRV analysis. The included individuals were divided into groups without pathological LV remodeling (R (-), n=57) and with pathological post-infarction LV remodeling (R (+), n=39), the criterion for which was an increase in end-diastolic and/or end-systolic volume >20% and >15%, respectively. Further, depending on the achievement of target low-density lipoprotein cholesterol (LDL-C) (1,5 mmol/l and/or a decrease of more than 50%), the following subgroups were identified: 17 (43,6%) people, who reached target LDL-C levels (group 1), 22 (56,4%) patients, who did not reach target LDL-C levels (group 2). Similar subgroups were identified in the R (-) group as follows: 28 (49,1%) people, who reached target LDL-C levels (group 3) and 29 (50,9%) people, who did not reach target LDL-C levels (group 4).Results. Starting from the 12th week of follow-up, worsening of global longitudinal (GLS), circumferential (GCS), and radial (GRS) strain (p<0,01) was registered in group 2. In group 1, worsening of these parameters was registered only by the 48th week (p<0,01). In group 3, an increase in GLS was revealed by the 48th week (p=0,001), GCS and GRS — by the 12th week (p<0,05). In group 4, favorable changes were observed only in GLS and GCS by the 48th week (p<0,01). A significant change in HRV parameters was observed in group 3. By the 48th week, there was an increase in temporal indicators (SDNN, SDNNi, SDANN, RMSSD, pNN50) (p<0,0001) and total spectrum power (p=0,0001) due to an increase in all frequency indicators (p<0,001), while the index of autonomic balance L/H decreased by 33% (p=0,002). In group 4, only SDNN, SDANN and pNN50 (p<0,05), as well as the total spectrum power (p=0,001) increased, but no change in frequencies. According to intergroup analysis in the acute period of STEMI, group 4 patients had higher HRV than in group 3 (p<0,05).Conclusion. High-dose atorvastatin therapy improves LV strain characteristics and autonomic balance during the rehabilitation period after STEMI.
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spelling doaj-art-a1ed8c8ff7c745a498a6629289cc844f2025-08-20T03:00:49Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202023-01-01271210.15829/1560-4071-2022-50783707Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapyV. E. Oleinikov0A. V. Golubeva1Yu. A. Barmenkova2A. V. Kulyutsin3N. V. Burko4M. V. Lukyanova5N. A. Donetskaya6Penza State UniversityPenza State UniversityPenza State UniversityN.N. Burdenko Penza Regional Clinical HospitalPenza State UniversityPenza State UniversityN.N. Burdenko Penza Regional Clinical HospitalAim. To study parameters of left ventricular (LV) strain and heart rate variability (HRV) in patients with ST-segment elevation myocardial infarction (STEMI) in various variants of postinfarction receiving high-dose atorvastatin therapy.Material and methods. The study included 96 patients with STEMI. All patients underwent two-dimensional speckle tracking echocardiography and 24-hour electrocardiographic monitoring with HRV analysis. The included individuals were divided into groups without pathological LV remodeling (R (-), n=57) and with pathological post-infarction LV remodeling (R (+), n=39), the criterion for which was an increase in end-diastolic and/or end-systolic volume >20% and >15%, respectively. Further, depending on the achievement of target low-density lipoprotein cholesterol (LDL-C) (1,5 mmol/l and/or a decrease of more than 50%), the following subgroups were identified: 17 (43,6%) people, who reached target LDL-C levels (group 1), 22 (56,4%) patients, who did not reach target LDL-C levels (group 2). Similar subgroups were identified in the R (-) group as follows: 28 (49,1%) people, who reached target LDL-C levels (group 3) and 29 (50,9%) people, who did not reach target LDL-C levels (group 4).Results. Starting from the 12th week of follow-up, worsening of global longitudinal (GLS), circumferential (GCS), and radial (GRS) strain (p<0,01) was registered in group 2. In group 1, worsening of these parameters was registered only by the 48th week (p<0,01). In group 3, an increase in GLS was revealed by the 48th week (p=0,001), GCS and GRS — by the 12th week (p<0,05). In group 4, favorable changes were observed only in GLS and GCS by the 48th week (p<0,01). A significant change in HRV parameters was observed in group 3. By the 48th week, there was an increase in temporal indicators (SDNN, SDNNi, SDANN, RMSSD, pNN50) (p<0,0001) and total spectrum power (p=0,0001) due to an increase in all frequency indicators (p<0,001), while the index of autonomic balance L/H decreased by 33% (p=0,002). In group 4, only SDNN, SDANN and pNN50 (p<0,05), as well as the total spectrum power (p=0,001) increased, but no change in frequencies. According to intergroup analysis in the acute period of STEMI, group 4 patients had higher HRV than in group 3 (p<0,05).Conclusion. High-dose atorvastatin therapy improves LV strain characteristics and autonomic balance during the rehabilitation period after STEMI.https://russjcardiol.elpub.ru/jour/article/view/5078myocardial infarctionpathological remodelingmyocardium strain cha racteristicsheart rate variability
spellingShingle V. E. Oleinikov
A. V. Golubeva
Yu. A. Barmenkova
A. V. Kulyutsin
N. V. Burko
M. V. Lukyanova
N. A. Donetskaya
Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapy
Российский кардиологический журнал
myocardial infarction
pathological remodeling
myocardium strain cha racteristics
heart rate variability
title Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapy
title_full Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapy
title_fullStr Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapy
title_full_unstemmed Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapy
title_short Myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high-dose atorvastatin therapy
title_sort myocardial strain parameters and autonomic balance in various variants of the postinfarction course in patients receiving high dose atorvastatin therapy
topic myocardial infarction
pathological remodeling
myocardium strain cha racteristics
heart rate variability
url https://russjcardiol.elpub.ru/jour/article/view/5078
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