BACKGROUND: Hyperglycemia was found to cause multiple adverse effects on myocardial muscle as it induces oxidative stress, enhances inflammation, and activates coagulation, which deteriorate myocardial damage in the setting of ischemia.
OBJECTIVE: Assess the impact of acute and chronic hyperglycemia on In-hospital and short term “6 months" outcomes in patients with acute myocardial infarction. And to assess the effect of hyperglycemia on left ventricular remodeling using speckle-tracking echocardiography.
SUBJECT AND METHODS: The Final study population was 100 patients who were divided according to A) Admission plasma glucose, into (2) groups: Non acute group: including (77) patients with RBS (< 200 mg/dl) and Acute group: including (23) patients with RBS (≥ 200 mg/dl). B) Glycated hemoglobin (HbA1c),to another (2) groups: Non chronic group: including (64) patients with normal HbA1c (< 6.5) and Chronic group: including (36) patients with elevated HbA1c (≥ 6.5).
RESULT: Patients with increased values of EDV, ESV and decreased values of EF and ś(parameters of worsening myocardial systolic function) in the patients with acute-HG in comparison with the patients without acute-HG, indicates that acute-HG is associated with deterioration of pump function of the heart (LV remodeling) . Regarding the GLS, our results showed that patients with both acute and chronic HG were having worse GLS in comparison with those without.
CONCLUSION: Both Acute and Chronic Hyperglycemia had been found to be associated with myocardial adverse effects in patients with AMI. And, 2D speckle echocardiography can be used as a good predictor of LV remodeling in those patients.