Purpose
Over the years, several parameters obtained by cardiac imaging techniques have been proposed, to evaluate left ventricular remodeling (LVR) that occurs in patients who have experienced an acute myocardial infarction (STEMI) despite effective coronary revascularization and optimal medical therapy[1]. In addition to the parameters traditionally evaluated by conventional and three-dimensional echocardiography such as the end-diastolic and end-systolic volumes of LV (EDV, ESV) and the ejection fraction (EF)[2-3], interest has been placed at the global longitudinal tension (GLS)[4]and recently at the myocardial area size with severe...
Methods and materials
From Cardiology Unit database we enrolled all patients with a diagnosis of STEMI on the basis of clinical presentation, electrocardiographic findings, and troponin elevation who underwent myocardial revascularization within 90 min from the onset of symptoms with the effective coronary flow after the procedure (TIMI III). Study inclusion criteria were an echocardiography exam performed with a dedicated protocol for speckle-tracking analysis within 7 days from the acute event and a CMR performed within 7 days and after 6 months for the study of LVR. Three...
Results
Forty-one consecutive patients (36 males, age 59 ± 10 years)were studied at baseline and after 6 months.According to the 6-month CMR LV-EDV variation, 10 patients (24%) showed LVR and 31 did not (76%). At baseline, LVR patients had a lower LV-EF, LV-GFI, GLS, and a higher MVO and SAS area. No significant differences were observed in terms of LV volumes and MSI although there was a trend for lower LV-EDV and higher LV-ESV mean values for LVR patients. At the univariable analysis,a significant correlation was...
Conclusion
In the present study, we showed that the SAS area was an excellent predictor of LVR and, when compared with other indices, it remained the only significant predictor of multivariable analysis. Indeed, it is known that the size of the SAS area is primarily an expression of the severely dysfunctional nonviable myocardium[5]. Regarding the CMR indices, in our patients, we found significant correlations between baseline LV-GFI and MVO with LVR at univariable analysis, while MSI did not correlate significantly. However, in multivariable analysis, none of...
Personal information and conflict of interest
F. Pellegrino; Ferrara/IT - nothing to disclose E. Chiodi; Ferrara/IT - nothing to disclose A. Cossu; Ferrara, FE/IT - nothing to disclose L. Marchetti; Ferrara/IT - nothing to disclose A. Carnevale; Ferrara/IT - nothing to disclose M. Giganti; Ferrara/IT - nothing to disclose G. Benea; Lagosanto (FE)/IT - nothing to disclose A. Squerzanti; Ferrara/IT - nothing to disclose
References
1.Galli A, Lombardi F. Postinfarct Left Ventricular Remodelling: A Prevailing Cause of Heart Failure. Cardiology Research and Practice. 2016.
2.Springeling T, Kirschbaum SW, Rossi A, Baks T, Karamermer Y, Schulz C, et al. Late cardiac remodeling after primary percutaneous coronary intervention: Five-year cardiac magnetic resonance imaging follow-up.Circ J. 2013;
3.Mele D, Teoli R, Cittanti C, Pasanisi G, Guardigli G, Levine RA, et al.Assessment of left ventricular volume and function by integration of simplified 3D echocardiography, tissue harmonic imaging and automated extraction of endocardial borders. Int...