Association of Endothelial Glycocalyx Integrity with Left Ventricular Performance and Remodeling after Acute Myocardial Infarction: A 12-month Follow-up Study

John Thymis; Konstantinos Katogiannis; George Pavlidis; Dimitrios Vlastos; Damianos Tsilivarakis; Gavriella Kostelli; John Parissis; Panagiota Efstathia Nikolaou; Ioanna Andreadou; Vaia Lambadiari; Ignatios Ikonomidis

doi:10.1055/a-2632-3249

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost
DOI: 10.1055/a-2632-3249

Endothelium and Angiogenesis

Association of Endothelial Glycocalyx Integrity with Left Ventricular Performance and Remodeling after Acute Myocardial Infarction: A 12-month Follow-up Study

Authors

John Thymis

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece
Konstantinos Katogiannis

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece
George Pavlidis

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece
Dimitrios Vlastos

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece
Damianos Tsilivarakis

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece
Gavriella Kostelli

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece
John Parissis

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece
Panagiota Efstathia Nikolaou

²School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
Ioanna Andreadou^†

²School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
Vaia Lambadiari

³2nd Department of Internal-Medicine, Diabetes Centre, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Ignatios Ikonomidis

¹2nd Department of Cardiology, School of Medicine University General Hospital “Attikon,” National and Kapodistrian University of Athens, Athens, Greece

Abstract

Background and Purpose

ST elevation myocardial infarction (STEMI) patients display endothelial dysfunction. We investigated whether endothelial glycocalyx thickness is affected in STEMI patients and may predict left ventricular performance post event.

Methods

We examined 278 STEMI patients and 140 matched controls. We measured: (a) perfused boundary region (PBR) of the sublingual microvessels (range 4 to 25 μm; increased value indicates reduced endothelial glycocalyx integrity) at baseline; (b) left ventricular ejection fraction (LVEF) and global longitudinal strain (LVGLS), at baseline and at 12 months, (c) the percentage change of left ventricular end-systolic volume (ΔLVESV) at 12 months.

Results

Compared with matched controls, STEMI patients had higher PBR4–25 (2.11 ± 0.17 μm vs. 1.98 ± 0.20 μm, p < 0.001). In a model including age, sex, hypertension, diabetes, hyperlipidemia, smoking, family history of coronary artery disease, number of diseased vessels, location of STEMI medication, and high-sensitivity troponin T (hs-troponin), PBR4–25 was independently associated with LVEF and LVGLS at 48 hours post-MI (for LVEF: unstandardized β coefficient: −4.71, 95% CI: −8.53 to −0.71, p = 0.019 and for LVGLS: 2.89, 95%CI: 1.63–4.16, p < 0.001). Using multivariable analysis, PBR4–25 remained a significant predictor of the percentage change in LVEF, LVGLS, and ΔLVESV at 12-month follow-up (LVEF change: unstandardized β coefficient: −1.38, 95% CI: −1.80 to −0.96, p < 0.001; for LV GLS change: −0.66, 95% CI: −1.14 to −0.18, p = 0.007 and for ΔLVESV: 1.42, 95% CI: 0.06–2.93, p = 0.039). A PBR4–25 cut-off value of 2.29 μm could detect LV EF less than 45% at 48 h as well as at 12 months (AUC: 0.82, p < 0.001 and AUC: 0.80; p < 0.001).

Conclusion

Endothelial glycocalyx assessment is associated with myocardial performance after STEMI.

Keywords

glycocalyx - ST elevation myocardial infarction - left ventricular global longitudinal strain - left ventricular ejection fraction

Full Text

References

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