TY - JOUR
T1 - Left Ventricular Dyssynchrony Acutely After Myocardial Infarction Predicts Left Ventricular Remodeling
AU - Mollema, Sjoerd A.
AU - Liem, Su San
AU - Suffoletto, Matthew S.
AU - Bleeker, Gabe B.
AU - van der Hoeven, Bas L.
AU - van de Veire, Nico R.
AU - Boersma, Eric
AU - Holman, Eduard R.
AU - van der Wall, Ernst E.
AU - Schalij, Martin J.
AU - Gorcsan, John
AU - Bax, Jeroen J.
N1 - Funding Information:
This study was supported by an unrestricted research grant from St. Jude Medical.
PY - 2007/10/16
Y1 - 2007/10/16
N2 - Objectives: We sought to identify predictors of left ventricular (LV) remodeling after acute myocardial infarction. Background: Left ventricular remodeling after myocardial infarction is associated with an adverse long-term prognosis. Early identification of patients prone to LV remodeling is needed to optimize therapeutic management. Methods: A total of 178 consecutive patients presenting with acute myocardial infarction who underwent primary percutaneous coronary intervention were included. Within 48 h of intervention, 2-dimensional echocardiography was performed to assess LV volumes, LV ejection fraction (LVEF), wall motion score index, left atrial dimension, E/E′ ratio, and severity of mitral regurgitation. Left ventricular dyssynchrony was determined using speckle-tracking radial strain analysis. At 6-month follow-up, LV volumes, LVEF, and severity of mitral regurgitation were reassessed. Results: Patients showing LV remodeling at 6-month follow-up (20%) had comparable baseline characteristics to patients without LV remodeling (80%), except for higher peak troponin T levels (p < 0.001), peak creatine phosphokinase levels (p < 0.001), wall motion score index (p < 0.05), E/E′ ratio (p < 0.05), and a larger extent of LV dyssynchrony (p < 0.001). Multivariable analysis demonstrated that LV dyssynchrony was superior in predicting LV remodeling. Receiver-operating characteristic curve analysis demonstrated that a cutoff value of 130 ms for LV dyssynchrony yields a sensitivity of 82% and a specificity of 95% to predict LV remodeling at 6-month follow-up. Conclusions: Left ventricular dyssynchrony immediately after acute myocardial infarction predicts LV remodeling at 6-month follow-up.
AB - Objectives: We sought to identify predictors of left ventricular (LV) remodeling after acute myocardial infarction. Background: Left ventricular remodeling after myocardial infarction is associated with an adverse long-term prognosis. Early identification of patients prone to LV remodeling is needed to optimize therapeutic management. Methods: A total of 178 consecutive patients presenting with acute myocardial infarction who underwent primary percutaneous coronary intervention were included. Within 48 h of intervention, 2-dimensional echocardiography was performed to assess LV volumes, LV ejection fraction (LVEF), wall motion score index, left atrial dimension, E/E′ ratio, and severity of mitral regurgitation. Left ventricular dyssynchrony was determined using speckle-tracking radial strain analysis. At 6-month follow-up, LV volumes, LVEF, and severity of mitral regurgitation were reassessed. Results: Patients showing LV remodeling at 6-month follow-up (20%) had comparable baseline characteristics to patients without LV remodeling (80%), except for higher peak troponin T levels (p < 0.001), peak creatine phosphokinase levels (p < 0.001), wall motion score index (p < 0.05), E/E′ ratio (p < 0.05), and a larger extent of LV dyssynchrony (p < 0.001). Multivariable analysis demonstrated that LV dyssynchrony was superior in predicting LV remodeling. Receiver-operating characteristic curve analysis demonstrated that a cutoff value of 130 ms for LV dyssynchrony yields a sensitivity of 82% and a specificity of 95% to predict LV remodeling at 6-month follow-up. Conclusions: Left ventricular dyssynchrony immediately after acute myocardial infarction predicts LV remodeling at 6-month follow-up.
UR - https://www.scopus.com/pages/publications/34948875321
UR - https://www.scopus.com/pages/publications/34948875321#tab=citedBy
U2 - 10.1016/j.jacc.2007.07.025
DO - 10.1016/j.jacc.2007.07.025
M3 - Article
C2 - 17936151
AN - SCOPUS:34948875321
SN - 0735-1097
VL - 50
SP - 1532
EP - 1540
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 16
ER -