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Abstract

B a c k g r o u n d: Today no established biomarkers are available for the early diagnosis of takotsubo syndrome and its differentiation from ST-segment elevation myocardial infarction. We hypothesized that copeptin and copeptin/NT-proBNP ratio may serve a routine marker combination for non-invasive differentiation.

M e t h o d s: The study compared the serum concentrations of copeptin, troponin I (TnI) and NT-proBNP in 19 consecutive women diagnosed with takotsubo syndrome according to the Mayo Clinic criteria and 10 consecutive women diagnosed with ST-segment elevation myocardial infarction.

R e s u l t s: Copeptin concentrations were significantly lower in patients with takotsubo syndrome than in patients with ST-segment elevation myocardial infarction. The diagnostic accuracy to distinguish takotsubo syndrome from ST-segment elevation myocardial infarction is highest for copeptin/NTproBNP ratio, copeptin/TnI at admission ratio and copeptin alone (AUC 0.8713, 0.8538, 0.8480, respectively).

C o n c l u s i o n s: The serum copeptin to NTproBNP ratio could be an additional tool in the non-invasive differentiation between takotsubo syndrome and ST-segment elevation myocardial infarction. However, further researches are needed.

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Authors and Affiliations

Monika Budnik
Sławomir Białek
Michał Peller
Agata Kiszkurno
Janusz Kochanowski
Jakub Kucharz
Dariusz Sitkiewicz
Grzegorz Opolski
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Abstract

Background: To assess and compare mid-term outcomes and the quality of life (QoL) in patients with multivessel coronary artery disease (MVD) and moderate ischemic mitral regurgitation (IMR), treated with either coronary artery bypass grafting (CABG; group I) or CABG + mitral annulo-plasty (CABG+MA; group II) in 12-months follow-up after surgery.
Methods: We prospectively analyzed 74 patients (50.7% female, 66 [67–72] years) with at least moderate IMR, 3–24 weeks after myocardial infarction (MI). The effective regurgitation orifice (ERO) was used for a quantitative IMR assessment. To evaluate QoL we used a Short Form-36 (SF-36) questionnaire.
Results: Patients in group II spent more time in the hospital, expired more infection complications and received more often in-hospital complications requiring use amines and intra-aortic balloon pump as compared to those in group I. Analysis of SF-36 showed that all patients treated surgically notable improved their QoL during 12 months of follow-up.
Conclusions: We observed a significant improvement in QoL among patients with MVD in 12 months follow-up after surgery irrespective of treatment type.
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Bibliography

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Authors and Affiliations

Radosław Piątkowski
1
Jakub Kucharz
2
Monika Gawałko
1 3 4
Monika Budnik
1
Katarzyna Wołosiewicz
5
Barbara Kozub
6
Janusz Kochanowski
1
Marcin Grabowski
1
Grzegorz Opolski
1

  1. 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
  2. Department of Uro-Oncology, Maria Skłodowska-Curie, National Research Institute of Oncology, Warsaw, Poland
  3. Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
  4. Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, Germany
  5. 1st Department of Pediatrics, Bielanski Hospital, Warsaw, Poland
  6. Department of Ophthalmology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Abstract

B a c k g r o u n d: Echocardiography is the first exam to establish the myocardial function in patients with takotsubo syndrome (TTS). However, ECG-Gated Myocardial Single-Photon Emission Tomography (G-SPECT) also allows to calculate left ventricular ejection fraction (LVEF) and can be useful in early stadium of TTS.

A i m: To compare LVEF obtained from 99mTc-MIBI G-SPECT and echocardiography in patients with TTS.

M a t e r i a l a n d M e t h o d s: Study population: 20 patients in medium age 77 (62–89) with TTS were included. In all patients 99mTc-MIBI G-SPECT and echocardiography was performed on the same day.

R e s u l t s: LVEF measured by G-SPECT and echocardiography ranged from 34 to 83% and 38 to 69%, respectively. The LVEF values for ECHO were significantly lower than for SPECT. The correlation between the LVEF was r = 0.76. The calculated correlation coefficient (r) for linear regression analysis was 0.64. The following equation shows the approximate interdependence of both LVEF calculations: LVEF GSPECT = 10.35 + 0.93 * LVEF Echo.

C o n c l u s i o n s: G-SPECT tends to overerestimate LVEF compared to echocardiography so these imaging techniques should not be used interchangeably. Calculated equation should be used for comparison of LVEF.

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Authors and Affiliations

Małgorzata Kobylecka
Monika Budnik
Janusz Kochanowski
Jakub Kucharz
Tomasz Mazurek
Adam Bajera
Leszek Królicki
Grzegorz Opolski

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