Vol 28, No 1 (2021)
Original Article
Published online: 2019-10-21

open access

Page views 1708
Article views/downloads 1516
Get Citation

Connect on Social Media

Connect on Social Media

The non-invasive evaluation of heart function in patients with an acute myocardial infarction: The role of impedance cardiography

Lukasz Lewicki1, Marta Fijalkowska2, Maciej Karwowski2, Konrad Siebert1, Grzegorz Redlarski3, Aleksander Palkowski3, Radoslaw Targonski2, Janusz Siebert4
Pubmed: 31642052
Cardiol J 2021;28(1):77-85.

Abstract

Background: The purpose of this study was to analyze hemodynamic changes in patients treated with
percutaneous coronary intervention (PCI) at an early stage of acute myocardial infarction (AMI) and at 1-month follow-up.

Methods: Patients with AMI (n = 27) who underwent PCI were analyzed using impedance cardiography
(ICG). ICG data were collected continuously (beat by beat) during the whole PCI procedure and thereafter at every 60 s for the next 24 h. Blood pressure was taken every 10 min and stored for analysis. Additionally the following parameters were measured: cardiac index (CI), stroke volume index (SVi), left cardiac work index (LCWi), contractility index (CTi), ventricular ejection time (VET), systemic vascular resistance index (SVRi), thoracic fluid content index (TFCi) and heart rate (HR).

Results: In the first 24 h after PCI all the contractility parameters including CI, SVi, LCWi, CTi and VET significantly decreased, whereas HR, SVRi and TFCi increased compared to baseline. All of the parameters examined got normalized at 1 month. The CI, SVi, LCWi, CTi, SVRi did not significantly differ from baseline, however the HR and VET were significantly lower compared to first day after PCI

Conclusions: Cardiac performance deteriorates early after PCI and normalizes after 1 month in patients with an AMI. ICG is useful for hemodynamic monitoring of AMI patients during and after invasive therapy.

Article available in PDF format

View PDF Download PDF file

References

  1. Hausenloy DJ, Yellon DM. Myocardial ischemia-reperfusion injury: a neglected therapeutic target. J Clin Invest. 2013; 123(1): 92–100.
  2. Braunwald E, Kloner RA. Myocardial reperfusion: a double-edged sword? J Clin Invest. 1985; 76(5): 1713–1719.
  3. Piper HM, García-Dorado D, Ovize M. A fresh look at reperfusion injury. Cardiovasc Res. 1998; 38(2): 291–300.
  4. Yellon D, Hausenloy D. Myocardial reperfusion injury. New Engl J Med. 2007; 357(11): 1121–1135.
  5. Kloner RA, Bolli R, Marban E, et al. Medical and cellular implications of stunning, hibernation, and preconditioning: an NHLBI workshop. Circulation. 1998; 97(18): 1848–1867.
  6. Krug A, Korb G. Blood supply of the myocardium after temporary coronary occlusion. Circ Res. 1966; 19(1): 57–62.
  7. Ito H. No-reflow phenomenon and prognosis in patients with acute myocardial infarction. Nature Clin Pract Cardiovasc Med. 2006; 3(9): 499–506.
  8. Luo AK, Wu KC. Imaging microvascular obstruction and its clinical significance following acute myocardial infarction. Heart Fail Rev. 2006; 11(4): 305–312.
  9. Hearse DJ, Tosaki A. Free radicals and reperfusion-induced arrhythmias: protection by spin trap agent PBN in the rat heart. Circ Res. 1987; 60(3): 375–383.
  10. Niu X, Zhang Q, Xiao D, et al. A retrospective study of hemodynamic changes in patients after off-pump coronary artery bypass graft surgery using impedance cardiography. Med Sci Monit. 2019; 25: 3454–3462.
  11. Louvaris Z, Spetsioti S, Andrianopoulos V, et al. Cardiac output measurement during exercise in COPD: A comparison of dye dilution and impedance cardiography. Clin Respir J. 2019; 13(4): 222–231.
  12. Małek ŁA, Mróz A, Czajkowska A, et al. Accuracy of impedance cardiography for hemodynamic assessment during rest and exercise in wheelchair rugby players. Res Q Exerc Sport. 2019; 90(3): 336–343.
  13. Kurpaska M, Krzesiński P, Gielerak G, et al. Exercise impedance cardiography reveals impaired hemodynamic responses to exercise in hypertensives with dyspnea. Hypertens Res. 2019; 42(2): 211–222.
  14. Woltjer HH, Bogaard HJ, Vries Pde. The technique of impedance cardiography. Eur Heart J. 1997; 18(9): 1396–1403.
  15. Silver MA, Cianci P, Brennan S, et al. Evaluation of impedance cardiography as an alternative to pulmonary artery catheterization in critically ill patients. Congest Heart Fail. 2004; 10(2 Suppl 2): 17–21.
  16. Sadauskas S, Naudžiūnas A, Unikauskas A, et al. Applicability of Impedance Cardiography During Heart Failure Flare-Ups. Med Sci Monit. 2016; 22: 3614–3622.
  17. B-Type natriuretic peptide and impedance cardiography testing at the time of routine echocardiography predict subsequent heart failure events. J Card Fail. 2005; 11(6): S123.
  18. Bhalla V, Isakson S, Bhalla MA, et al. Diagnostic ability of B-type natriuretic peptide and impedance cardiography: testing to identify left ventricular dysfunction in hypertensive patients. Am J Hypertens. 2005; 18(2 Pt 2): 73S–81S.
  19. Castellanos LR, Bhalla V, Isakson S, et al. B-type natriuretic peptide and impedance cardiography at the time of routine echocardiography predict subsequent heart failure events. J Card Fail. 2009; 15(1): 41–47.
  20. Ablonskytė-Dūdonienė R, Bakšytė G, Ceponienė I, et al. Prognosis of in-hospital myocardial infarction course for diabetic and nondiabetic patients using a noninvasive evaluation of hemodynamics and heart rate variability. Medicina (Kaunas). 2013; 49(6): 262–272.
  21. Brazdzionyte J, Macas A. Impedance cardiography for aortic balloon counterpulsation impact assessment on patients hemodynamics during acute myocardial infarction. Medicina (Kaunas). 2006; 42(11): 904–913.
  22. Neri M, Riezzo I, Pascale N, et al. Ischemia/Reperfusion Injury following Acute Myocardial Infarction: A Critical Issue for Clinicians and Forensic Pathologists. Mediators Inflamm. 2017; 2017: 7018393.
  23. Chen SJ, Gong Z, Duan QL. Evaluation of heart function with impedance cardiography in acute myocardial infarction patients. Int J Clin Exp Med. 2014; 7(3): 719–727.
  24. Malfatto G, Blengino S, Perego GB, et al. Transthoracic impedance accurately estimates pulmonary wedge pressure in patients with decompensated chronic heart failure. Congest Heart Fail. 2012; 18(1): 25–31.