Prognostic implications of left ventricular dyssynchrony early after non-ST elevation myocardial infarction without
Arnold C T Ng1, Da T Tran, Christine Allman
1Department of Cardiology, Liverpool Hospital, University of New South Wales, Elizabeth Street, Liverpool, Sydney, NSW 2170, Australia.
European Heart Journal
|November 26, 2009
Summary
Left ventricular (LV) dyssynchrony after non-ST elevation myocardial infarction (NSTEMI) is predicted by proximal left circumflex artery stenosis and poor LV function. A composite dyssynchrony score predicts long-term LV dysfunction.
Area of Science:
- Cardiology
- Cardiac Imaging
- Heart Failure Research
Background:
- Left ventricular (LV) dyssynchrony is a significant complication following non-ST elevation myocardial infarction (NSTEMI).
- Predicting long-term LV dysfunction after NSTEMI remains a clinical challenge.
Purpose of the Study:
- To identify independent predictors of LV dyssynchrony post-NSTEMI.
- To evaluate the prognostic value of combining dyssynchrony parameters for predicting long-term LV dysfunction.
Main Methods:
- 100 NSTEMI patients underwent LV dyssynchrony assessments.
- A composite dyssynchrony score was utilized.
- Patients were followed for 1 year to assess long-term LV function.
Main Results:
- Proximal left circumflex artery (LCx) stenosis and global systolic dysfunction independently predicted early LV dyssynchrony.
- Absence of early dyssynchrony, fewer diseased vessels, and revascularization were associated with improved LV volumes and ejection fraction over time.
- The composite dyssynchrony score independently predicted persistent LV dilation and low ejection fraction at follow-up.
Conclusions:
- Proximal LCx stenosis and impaired LV function are independent predictors of LV dyssynchrony after NSTEMI.
- The composite dyssynchrony score demonstrates prognostic value, identifying patients at risk for persistent LV dilation and dysfunction.
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