Impedance Cardiography Application In Acute Myocardial Infarction

BackgroundCardiovascular disease is one of the most harmful diseases to human health with the improvement of the people's living standard. Acute myocardial infarction is one of the severe diseases. The early diagnosis and timely treatment have been the problems that should be solved quickly. Percutaneous coronary intervention (PCI) is an important method to treat acute ST-elevation myocardial infarction. Primary PCI means to perform balloon inflation and stent implantation within 12 hours. It is important to monitor hemodynamics to investigate the condition of patients and the effect of the treatment with percutaneous coronary intervention. For many years pulmonary artery catheter was be considered the gold standard. But it is invasive, difficult and technical. Impedance cardiography (ICG) is noninvasive, safe and accurate.It has been documented that ICG is as exactly as Swan-Ganz flow-directed thermodilution catheterization. It has an important value in the fields of cardiology. It has been used more widely in patients with heart failure. It is rarely applied in patients with acute myocardial infarction.ObjectiveFor evaluating ICG further, we explored the differences of ICG parameters in acute ST-elevation myocardial infarction and analyzed the changes after Primary PCI.And discussed the value of ICG parameters in acute ST-elevation myocardial infarction.MethodsSubjects:Patients:53 patients suffering with acute ST-elevation myocardial infarction, they were hospitalized in Qilu Hospital of Shandong University from Sep.2010 to Feb.2011.According to their therapy, they were divided into two groups, the primary PCI group,26 patients, aged 59.54±9.86 yrs,17 men and 9 women; the non-primary PCI group,27 patients, aged 62.81±9.80yrs,14 men and 8 women. Healthy control group:30 healthy volunteers,age≥40 yrs, aged 58.37±7.49 yrs,19 men and 11 women.Instrument:Bioz.com noninvasive hemodynamic monitor system (BioZ ICG Monitor, CardioDynamics, San Diego, CA).Hemodynamic parameters:HR, SBP, DBP, MAP, CO/CI, SV/SI, VI, ACI, TFC, VR/SVRI, LCW/LCWI, PEP, LVET, STR. Data were analyzed by SPSS 10.0.Results1.The primary PCI group before the surgery: compared with the healthy control group,the CO/CI,SV/SI,VI,ACI,LCW/LCWI decreased significantly (P<0.05); while SVR/SVRI increased significantly (P<0.05).2. The primary PCI group after 24 hours: compared with that before the surgery, the CO/CI, SV/SI, LCW/LCWI decreased significantly (P<0.05).3. The primary PCI group after 1 week: compared with that before the surgery, its SVR/SVRI deceased significantly(P<0.05).4. The primary PCI group after 1 week:compared with the non-emergency PCI group, CO/CI, SV/SI, VI, ACI, LCW/LCWI increased significantly (P<0.05), SVR/SVRI deceased significantly(P<0.05).ConclusionIn acute myocardial infarction patients, cardiac function was damaged. ICG examination is helpful to make hemodynamic assessment in STEMI. It is a useful and optional tool to evaluate the follow-up effect of primary PCI.