The effect of postinfarction cardiosclerosis placement on diastolic functionality and concentration of natriuretic peptides

Abstract

Aim. The aim of this study is to assess the impact of post-infarction cardiosclerosis locali
zation on left ventricular diastolic function and natriuretic peptide levels in patients after
myocardial infarction.
Patients. The study included 150 patients (mean age 51±8 years) who had suffered an acute
myocardial infarction no more than 3 months ago and had confirmed post-infarction car
diosclerosis diagnosed based on echocardiography. Patients were divided into two groups depending on the location of cardiosclerotic changes:1) patients with anterior localization of
the post-infarction scar (n=78);2) patients with posterior localization of the post-infarction
scar (n=72); The study included patients with preserved systolic function of the LV (LVEF
was more than 50%).
Results. The study yielded the following results demonstrating the relationship between
the localization of post-infarction cardiosclerosis, diastolic function, and natriuretic peptide
levels. Echocardiographic data analysis showed that patients with left ventricular anterior
wall cardiosclerosis had significantly worse diastolic function compared to other groups. The
mean E/A ratios were 0,83±0.2 and 0,78±0.32 for the anterior and posterior wall groups,
respectively. Tissue Doppler velocity (e’) values were also lower in the anterior wall group.
Enzyme immunoassay revealed statistically significant elevated N-terminal pro b-type nat
riuretic peptide BNP (NT-proBNP) levels in patients with anterior wall cardiosclerosis. The
mean NT-proBNP levels were 580 pg/ml for the anterior wall and 456 pg/ml for the poste
rior wall.
Conclusion. The study showed a significant effect of the localization of postinfarction cardi
osclerosis on the diastolic function of the left ventricle and the levels of natriuretic peptides
in patients after acute myocardial infarction. Particularly significant changes were found in
patients with cardiosclerosis of the anterior wall of the left ventricle, who demonstrated wor
se diastolic function and increased levels of natriuretic peptides compared to other groups.