Argishti Kristosturyan

Yerevan State Medical University, Armenia

Clinical Significance of Combined Myocardial Performance Index in the Risk Stratification of Acute Stemi

Biography

He is a practicing cardiologist with a specialized focus in echocardiography, committed to advancing cardiovascular care through precise diagnostics and evidence-based practice. He graduated from Yerevan State Medical University in 2021 and completed his cardiology residency in 2024. Throughout his training and clinical practice, he developed a strong interest in non-invasive cardiac imaging.

As an echocardiography specialist, he is actively involved in both clinical and academic settings, contributing to research and continuing education in cardiac imaging. He is passionate about knowledge sharing and remains engaged with the latest innovations in cardiovascular medicine. Speaking at professional conferences provides him with a valuable opportunity to contribute to the cardiology community and exchange insights with leading experts in the field.

Abstract

Objectives: This study aims to evaluate the predictive utility of combined myocardial performance index (CMPI), a novel echocardiographic marker, assessed during the acute phase in STEMI patients.

Methods: The study enrolled 240 STEMI patients receiving primary PCI. Echocardiographic evaluation was conducted within 24 hours following symptom onset, before primary PCI, measuring both LV MPI and RV MPI. MPI calculation involved summing isovolumic contraction time (ICT) and isovolumic relaxation time (IRT), then dividing by ejection time (ET): MPI = (ICT + IRP) / ET. Anterior STEMI occurred in 50% of patients. Concomitant RV myocardial infarction (MI) was present in 30 patients (12.5%). Patient stratification created two cohorts: Group 1 – CMPI > 0.9 (110 patients), and Group 2 – CMPI ? 0.9 (130 patients). Baseline demographic and clinical parameters were comparable between groups. Additionally, no differences existed regarding LV MI location and concurrent RV MI. Primary endpoints were in-hospital and one-year cardiovascular mortality rates. The secondary endpoint was the one-year heart failure hospitalization rate.

Results: Group 1 demonstrated 9.1% in-hospital mortality versus 3.1% in Group 2 (p = 0.0489). One-year cardiovascular mortality rates were 12.7% in Group 1 compared to 5.4% respectively (p = 0.0465). One-year heart failure hospitalization rate was significantly reduced in Group 2 (22.7% vs. 12.3%, p = 0.0332).

Conclusion: CMPI demonstrates potential as a novel predictor for in-hospital and one-year cardiovascular mortality and one-year heart failure hospitalization rates in acute STEMI patients.