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Permanent Ligation of the Left Anterior Descending Coronary Artery in Mice: A Model of Post-myocardial Infarction Remodelling and Heart Failure
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Left ventricular remodeling and ventricular arrhythmias after myocardial infarction

Martin St John Sutton1, Douglas Lee, Jean Lucien Rouleau

  • 1Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA. suttonm@mail.med.upenn.edu

Circulation
|May 7, 2003
PubMed

Insights

Left ventricular remodeling after heart attack predicts dangerous heart rhythms. Echocardiography can assess left ventricular size, mass, and function to identify patients at risk for ventricular arrhythmias.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Cardiovascular Imaging

Background:

  • The relationship between left ventricular (LV) remodeling and ventricular arrhythmias post-myocardial infarction is not well understood.
  • LV remodeling, including changes in size, hypertrophy, and function, may contribute to arrhythmogenesis.

Purpose of the Study:

  • To investigate the association between LV remodeling parameters and ventricular arrhythmias after myocardial infarction.
  • To determine if quantitative echocardiographic measures predict the occurrence of ventricular tachycardia (VT) and frequent premature ventricular contractions (PVCs).

Main Methods:

  • Quantitative 2D echocardiography and ambulatory ECG monitoring were performed in 263 patients post-myocardial infarction.
  • LV size, LV muscle (mass) area (LVMA), and function were assessed at baseline, 1 year, and 2 years.
  • Prevalence of VT and frequent PVCs (>10/h) was determined from ECG monitoring.

Main Results:

  • VT and frequent PVCs were observed in 20-23% and 29-39% of patients, respectively, over 2 years.
  • Baseline and longitudinal LV size, LVMA, and function were significantly associated with ventricular arrhythmias.
  • Changes in LV size and function over 2 years predicted VT and frequent PVCs.

Conclusions:

  • Quantitative echocardiographic assessment of LV remodeling predicts ventricular arrhythmias post-infarction.
  • Altered LV architecture and function during postinfarction remodeling create a substrate for high-grade ventricular arrhythmias.
Abstract

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