PSU: A system for assessing the risk of developing ventricular tachycardia

Main article: Myocardial infarction

2025: Development of a system to assess the risk of developing ventricular tachycardia

Scientists have identified markers for the more likely development of ventricular tachycardia after. heart attack Among them are the NT-proBNP heart failure indicator in, blood post-infarct scar size, cardiac contractility, and parameters. ECG The authors came to this conclusion by analyzing blood tests, ECGs data , and in 80 patients after a heart attack. MRI ULTRASONOGRAPHY hearts The results will help doctors predict the development of ventricular tachycardia after myocardial infarction and take measures in time to adjust patients' treatment and avoid this complication. This was Russian Science Foundation (RSF) announced on April 22, 2025.

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Фото: RSF

In about 7% of cases, patients who have had myocardial infarction experience sudden cardiac death. It manifests itself in the case when people receiving treatment after an acute illness suddenly die from concomitant disorders in the heart. The most common cause of death in this case is ventricular tachycardia - conditions when the heart beats too quickly, chaotically, and its contractions become ineffective and do not provide blood circulation through the body. Therefore, physicians seek to develop strategies for the care of patients after a heart attack with a high risk of sudden cardiac death that will prevent death.

Scientists from Penza State University (Penza) have developed a system to assess the risk of developing ventricular tachycardia in people after suffering a myocardial infarction. The science team worked with 80 patients in their 30s and 70s who had a recent heart attack.

The study participants underwent a comprehensive examination: they took blood for analysis, did an ECG, as well as an MRI and ultrasound of the heart. Thus, doctors determined in the blood of patients admitted to the hospital with a diagnosis of myocardial infarction, the level of troponin I - an indicator of acute heart injury. On days 7-9 after infarction, the authors examined the values ​ ​ of the NT-proBNP marker of heart failure.

In addition to laboratory research, on day 7-9, patients underwent MRI and ultrasound of the heart. This made it possible to assess how much the organ is affected by a heart attack and how it functions after it. To understand how the heart contracts and whether its rhythm is disturbed, scientists for three days removed ECG indicators from the study participants.

According to the results of the electrocardiogram, rhythm disorders, or arrhythmia, were detected in 10 out of 80 patients. They had so-called "ventricular tachycardia runs," when suddenly the heart began to contract too quickly and inefficiently. In five patients with this condition, arrhythmia occurred on the third day after a heart attack, in four - on the second day, and only in one patient - in the first 24 hours. The remaining 70 people without a heart rhythm disorder entered the comparison group.

In patients with ventricular tachycardia, the mean NT-proBNP marker of heart failure was twice as high as in the comparison group. They also had a mass of scar - functionally inactive connective tissue that replaced normal heart cells during a heart attack - on average was 2.2 times more. It is indirectly determined by different parameters detected on cardiac MRI with contrast. For this purpose mass of myocardium and post-infarction scar is calculated.

Also, in patients with tachycardia, even before the infarction, coronary heart disease was more common (chronic damage to the heart muscle caused by a decrease or cessation of blood flow through the coronary arteries) - in 50% of cases versus 20% in the comparison group. Troponin I and creatinine levels were not significantly different.

Based on these data, scientists have compiled a multifactorial system that, according to the patient data set, predicts the risk of developing ventricular tachycardia in patients. This system is a list of indicators that a doctor should focus on when managing patients after a heart attack. The risk factors included the presence of a history of coronary heart disease, high levels of the marker of heart failure NT-proBNP in the blood, a large mass of post-infarct scar on the heart, contractility of the heart and ECG parameter. The application of this model in clinical practice, according to the authors, will allow earlier and more accurate detection of the risks of sudden cardiac death from ventricular tachycardia.

{{quote 'At the next stage, we will continue to monitor patients enrolled in the study for 1-2 years. According to the results of the examination - heart MRI and multi-day ECG monitoring - we plan to establish the relationship between the peculiarities of the structure of the heart muscle, its electrical activity and their role in the development of arrhythmias long after the heart attack, "said Elena Averyanova, Candidate of Medical Sciences, Associate Professor of the Department of Therapy at Penza State University. }}