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Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
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Impact of left ventricular dyssynchrony early on left ventricular function after first acute myocardial infarction

Gaetano Nucifora1, Matteo Bertini, Nina Ajmone Marsan

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

The American Journal of Cardiology
|January 28, 2010
PubMed

Insights

Left ventricular (LV) dyssynchrony significantly impairs LV function after acute myocardial infarction (AMI). This dyssynchrony, measured by the systolic dyssynchrony index (SDI), worsens LV ejection fraction (EF) beyond infarct size.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Mechanics

Background:

  • Left ventricular (LV) dyssynchrony's impact on LV ejection fraction (EF) post-acute myocardial infarction (AMI) is not fully understood.
  • Assessing LV function and dyssynchrony is crucial for understanding post-MI outcomes.

Purpose of the Study:

  • To investigate the relationship between LV dyssynchrony and LV ejection fraction (EF) after AMI.
  • To determine if LV dyssynchrony has an independent impact on LV systolic function.

Main Methods:

  • Included 129 patients with ST-elevation AMI and QRS duration <120 ms undergoing primary PCI.
  • Utilized real-time 3D echocardiography and myocardial contrast echocardiography to assess LV function, dyssynchrony (systolic dyssynchrony index [SDI]), and infarct size.
  • Defined LV dyssynchrony as the standard deviation of time to minimum systolic volume for 16 LV segments.

Main Results:

  • Patients with AMI exhibited significantly higher SDI (5.24 ± 2.23%) compared to controls (2.02 ± 0.70%, p < 0.001).
  • Higher SDI was observed in AMI patients with LVEF < 45% versus those with LVEF ≥ 45% (6.95 ± 2.40% vs 4.29 ± 1.44%, p < 0.001).
  • Multivariate analysis revealed SDI was independently related to LVEF, with an incremental detrimental effect on LV function beyond infarct size and anterior AMI location.

Conclusions:

  • LV synchronicity is significantly impaired early after AMI.
  • LV dyssynchrony is closely related to LVEF and detrimentally affects LV systolic function independently of infarct size and AMI location.

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