Related Experiment Video
Updated: Sep 26, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Heart failure after myocardial infarction: prevalence of preserved left ventricular systolic function in the
Jens P Hellermann1, Steven J Jacobsen, Guy S Reeder
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.
Insights
A significant portion of heart failure patients after myocardial infarction (MI) have preserved ejection fraction (LVEF). This condition, known as congestive heart failure (CHF) with preserved LVEF, is more common in women and associated with smaller MI size.
Area of Science:
- Cardiology
- Heart Failure Research
- Myocardial Infarction Studies
Background:
- Congestive heart failure (CHF) with preserved left ventricular ejection fraction (LVEF) is recognized in mixed etiologies.
- The prevalence of CHF with preserved LVEF specifically in patients post-myocardial infarction (MI) remains largely unknown.
- This study investigates the occurrence and characteristics of preserved LVEF in patients experiencing CHF following an MI.
Purpose of the Study:
- To determine the prevalence of preserved LVEF in patients with CHF post-MI.
- To identify clinical characteristics associated with CHF and preserved LVEF in this population.
- To understand the implications of preserved LVEF in heart failure following myocardial infarction.
Main Methods:
- A population-based cohort study was conducted in Olmsted County, Minnesota.
- Validated criteria (Framingham for CHF, standardized epidemiological for MI) were used for patient selection.
- Clinical data, including LVEF and creatinine phosphokinase levels, were collected and analyzed.
Main Results:
- Of 1658 patients with MI, 644 (38%) developed CHF. Among those with LVEF assessment (n=395), 30% had preserved LVEF (> or =50%).
- Preserved LVEF was more prevalent in women (37%) than men (23%), a finding that remained significant after adjustment (OR 1.97).
- Higher peak creatinine phosphokinase levels were negatively associated with preserved LVEF (OR 0.51), suggesting smaller infarct size.
Conclusions:
- A substantial proportion of patients with CHF following MI exhibit preserved LVEF.
- This highlights the significant burden of CHF with preserved LVEF in patients with established coronary artery disease.
- Female sex and smaller myocardial infarction size are associated with CHF and preserved LVEF post-MI.
Background:
Studies have reported that a large proportion of the cases of congestive heart failure (CHF) with mixed etiologies have preserved left ventricular systolic function. Whether this is the case in subjects with CHF after myocardial infarction (MI) is not known. This study was undertaken to examine the prevalence and characteristics associated with CHF in patients who had preserved ejection fraction (LVEF) after MI.
Methods:
Clinical characteristics and LVEF were ascertained in a population-based cohort of patients with CHF after incident MI in Olmsted County, Minn. All MIs were validated by use of standardized epidemiological criteria, and all episodes of CHF were validated by use of Framingham criteria.
Results:
Between 1979 and 1994, 1658 patients had an MI, and 644 of these patients (38%) had CHF during 7.4 +/- 5.4 years of follow-up. Of these patients, 395 (61%) underwent LVEF assessment. Preserved LVEF (ie, > or =50%) was present in 30% of cases, and this proportion did not change with time. The proportion of women with CHF and preserved LVEF (37%) was greater than the proportion of men (23%, P =.002). The positive association between female sex and preserved LVEF remained significant after adjustment (odds ratio 1.97, 95% CI 1.26-3.07, P =.003). The highest tertile of peak creatinine phosphokinase level was negatively associated with preserved LVEF (odds ratio 0.51, 95% CI 0.29-0.89).
Conclusion:
A notable proportion of cases of CHF after MI have preserved LVEF. This underscores the burden of CHF with preserved LVEF in a well-defined group of patients with documented coronary disease. CHF with preserved LVEF after MI is associated with female sex and smaller MI size.
Related Concept Videos
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
01:17Pathophysiology of Heart Failure
01:27Heart Failure I: Introduction
01:29Heart Failure II: Pathophysiology
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy