Résumé
We investigated the relationship of traditional left ventricular (LV) volume indices, LV ejection fraction (LVEF) infarct size, LV sphericity and conicity indices and longitudinal shortening with left ventricular remodeling at one year.
LV sphericity and conicity indices have been presented as pathological indices of LV remodeling in the general population. Small studies have reported a predictive value of these indices at the acute phase of MI on chronic LV remodeling.
Contrast enhanced cardiac magnetic resonance (CMR) studies were performed in 102 anterior ST-elevated myocardial infarction patients from the CIRCUS trial (CMR substudy) treated with primary percutaneous coronary intervention (PCI). CMR examination was performed 5±2 days after reperfusion. LV remodeling was measured as the relative increase in LV enddiastolic volume between the acute phase and and one-year follow-up as assessed by cardiac ultrasound. Adverse LV remodeling was defined as an increase in LV-end-diastolic volume ≥20%.
LV remodeling in the study population was 10.0% IQR [–10.9%; 30.2%]. Upon univariate linear regression, One-year LV remodeling was significantly related to infarct size (R=0.51; p<0.001) (Figure), LVEF (R=–0.29; p=0.03) and longitudinal shortening (R=0.31; p=0.02). All other indices assessed at the acute phase were not significantly related to chronic LV remodeling (Table). Infarct size was strongly correlated with LVEF (R=-0.68; p<0.001), indexed LVESV (R=0.50; p<0.001) and longitudinal shortening (R=0.31; p=0.003). 65 (64%) had adverse LV remodeling at one year.
At the acute phase of MI, LVEF and longitudinal shortening showed the strongest correlation with infarct size whereas there were modest or non significant correlation with more sophisticated LV indices of remodeling.
The author hereby declares no conflict of interestTable 1TableCMR ParameterR valueP valueInfarct size0,510,001LVEF %–0,280,03LVEDV index, ml/m20,090,50LVESV index, ml/m20,230,08Sphericity index–0,00090,94Conicity index0,200,15Longitudinal shortening, %0,320,03 [Display omitted]