Biblioteca Virtual en Salud

Objective To explore the disparity of severity of cardiac dysfunction and recovery among different glycometabolic patients in the early phase of acute myocardial infarction (AMI) . Methods Consecutive 111 AMI patients without known diabetes underwent continuous glucose monitoring. Patients with different glycometabolic status were compared in terms of cadiac dysfunction and recovery at admission and 3month follow up. Results Compared to patients with normglycemia and transient hyperglycemia, patitents with persistent hyperglycemia were more likely to grade Killip Ⅱ or above,which were 13.3% (4/30) ,33. 3% ( 12/36) ,55. 6% (25/45), 20. 0% ( 6/30), 41.7% ( 15/36 ) and 93.3% (42/45) ( Ps ＜ 0. 01 ). In-hospital left ventricular ejection fraction (LVEF), mitral valve protodiastolic E peak velocities (E) and its ratio to late diastolic (E/A) decreased significantly ( LVEF0. 52 ± 0. 02,0. 48 ± 0. 01 and 0. 37 ± 0. 02; E [0. 65 ± 0. 41]m/s,[0.55 ± 0.02] m/s and [0.39 ±0. 12]m/s;E/A1. 15 ±0.08,1.02 ±0.06 and 0.61 ±0.02,respectively) ( Ps ＜ 0. 01 ), whereas LVESV and WMSI increased significantly ( LVESV [25.83 ± 0. 51] ml,[31.26 ± 1.23] ml, [37, 72 ± 1.01] ml; WMSI 1.5 ± 0. 3,1.8 ± 0. 2 and 2. 6 ± 0. 4, respectively) ( Ps ＜ 0. 01 )There months after AMI,patitents with persistent hyperglycemia were more likely to grade NYHA Ⅱ or above compared to patients with normglycemia and transient hyperglycemia [67.5% (27/40), 10.0% (3/30) and 11.8% (4/34),respectively] (P ＜0. 01 ). Echocardiographic recovery was observed in each group,but less in persistent hyperglycemia patients. Conclusion Cardiac function of patients with persistent hyperglycemia suffered more severely from AMI and difficult to recover.