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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
PubMed

Insights

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.
Abstract

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