39 -5 (91) 2026 - Zhabborova N.M., Orinbaev Sh.A. - NON-INVASIVE CRITERIA FOR PATHOLOGICAL REMODELING OF THE LEFT VENTRICLE IN YOUNG PATIENTS (≤45 YEARS) AFTER ACUTE MYOCARDIAL

NON-INVASIVE CRITERIA FOR PATHOLOGICAL REMODELING OF THE LEFT VENTRICLE IN YOUNG PATIENTS (≤45 YEARS) AFTER ACUTE MYOCARDIAL INFARCTION

Zhabborova N.M. - Republican Specialized Scientific and Practical Medical Center of Cardiology

Orinbaev Sh.A. - Republican Specialized Scientific and Practical Medical Center of Cardiology

Bekmetova F.M. - Republican Specialized Scientific and Practical Medical Center of Cardiology

Karimov B.S. - Republican Specialized Scientific and Practical Medical Center of Cardiology

Doniyorov Sh.N. - Republican Specialized Scientific and Practical Medical Center of Cardiology

Bekmetova S.I. - Republican Specialized Scientific and Practical Medical Center of Cardiology

Ilkhomova L.T. - Republican Specialized Scientific and Practical Medical Center of Cardiology

Resume

A study of 139 young patients (≤45 years) 78 days after acute myocardial infarction found that 58.3% had persistently reduced or moderately reduced LVEF, and pathological global longitudinal strain (|GLS| <16%) was recorded in 81.3% of patients, including 76% with formally preserved LVEF ≥50%. This supports the concept of subclinical systolic dysfunction. Stratification by EF revealed two polar phenotypes of post-infarction remodeling: decompensated eccentric (increased iEDV, EDV, ESV, iLVM, decreased RVOT, NT-proBNP 985 pg/ml vs. 263 pg/ml; p<0.001) with EF <50% and relatively concentric with less pronounced dilation with EF ≥50%; the iEDV threshold of 51 ml/m² was determined as the optimal demarcation point between pathological and non-pathological remodeling. The obtained data justify the use of a set of non-invasive criteria—iEDV ≥51 ml/m², |GLS| <16%, and increased NT-proBNP—and the mandatory inclusion of speckle-tracking echocardiography in the examination algorithm for young post-infarction patients, regardless of the EF level.

Key words: non-invasive criteria for pathological remodeling of the left ventricle, young patients (≤45 years), acute myocardial infarction.

First page

219

Last page

229

For citation:Zhabborova N.M., Orinbaev Sh.A., Bekmetova F.M., Karimov B.S., Doniyorov Sh.N., Bekmetova S.I., Ilkhomova L.T. - NON-INVASIVE CRITERIA FOR PATHOLOGICAL REMODELING OF THE LEFT VENTRICLE IN YOUNG PATIENTS (≤45 YEARS) AFTER ACUTE MYOCARDIAL INFARCTION//New Day in Medicine 5(91)2026 219-229 https://newdayworldmedicine.com/en/new_day_medicine/5-91-2026

List of References

1. World Health Organization. World health statistics 2019: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.
2. Статистический анализ. PLOS Global Public Health. 2024 Nov 20.
3. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1–39.e14. doi:10.1016/j.echo.2014.10.003.
4. Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R, et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardise deformation imaging. Eur Heart J Cardiovasc Imaging. 2015;16(1):1–11. doi:10.1093/ehjci/jeu184.
5. Chew DS, Heikki H, Schmidt G, Kavanagh KM, Dommasch M, Bloch-Thomsen PE, et al. Change in left ventricular ejection fraction following first myocardial infarction and outcome. JACC Clin Electrophysiol. 2018;4(5):672–682. doi:10.1016/j.jacep.2017.12.015.
6. Yalta K, Yilmaz MB, Yalta T, Palabiyik O, Taylan G, Zorkun C. Late versus early myocardial remodeling after acute myocardial infarction: a comparative review on mechanistic insights and clinical implications. J Cardiovasc Pharmacol Ther. 2020;25(1):15–26. doi:10.1177/1074248419869618.
7. Reindl M, Tiller C, Holzknecht M, Lechner I, Henninger B, Mayr A, et al. Global longitudinal strain by feature tracking for optimized prediction of adverse remodeling after ST-elevation myocardial infarction. Clin Res Cardiol. 2021;110(1):61–71. doi:10.1007/s00392-020-01649-2.
8. Reindl M, Tiller C, Holzknecht M, Lechner I, Eisner D, Riepl L, et al. Global longitudinal strain improves risk assessment after ST-segment elevation myocardial infarction: a comparative prognostic evaluation of left ventricular functional parameters. Clin Res Cardiol. 2022;111(4):416–425. doi:10.1007/s00392-021-01875-2.
9. Oleynikov VE, Salyamova LI, Kvasova OG, Burko NV. Prediction of adverse post-infarction left ventricular remodeling using a multivariate regression model. Diagnostics (Basel). 2022;12(3):770. doi:10.3390/diagnostics12030770.
10. Frantz S, Hundertmark MJ, Schulz-Menger J, Bengel FM, Bauersachs J. Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies. Eur Heart J. 2022;43(27):2549–2561. doi:10.1093/eurheartj/ehac223.
11. Sinkin VA, Stelmashok VI, Kalinin AO, Polonetsky OL, Mrochek AG. Serum and echocardiographic markers may synergistically predict adverse cardiac remodeling after ST-segment elevation myocardial infarction in patients with preserved ejection fraction. Diagnostics (Basel). 2020;10(5):301. doi:10.3390/diagnostics10050301.
12. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes: developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J. 2023;44(38):3720–3826. doi:10.1093/eurheartj/ehad191.\

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