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Influence of left ventricular hypertrophy on infarct size and left ventricular ejection fraction in ST-elevation

Łukasz A Małek1, Mateusz Spiewak, Mariusz Kłopotowski

  • 1Department of Interventional Cardiology and Angiology, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland.

European Journal of Radiology
|February 18, 2011
PubMed

Insights

Patients with left ventricular hypertrophy (LVH) undergoing ST-segment elevation myocardial infarction (STEMI) have larger infarct sizes. This larger infarct size is often underestimated by left ventricular ejection fraction (LVEF) measurements.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Myocardial Infarction

Background:

  • Left ventricular hypertrophy (LVH) is associated with increased infarct size in ST-segment elevation myocardial infarction (STEMI).
  • Left ventricular ejection fraction (LVEF) may underestimate infarct size in LVH patients due to preserved systolic function.
  • Cardiac magnetic resonance (CMR) is utilized to assess infarct size and LVH.

Purpose of the Study:

  • To compare infarct size and LVEF in STEMI patients with and without LVH using CMR.
  • To investigate the relationship between LVH, infarct characteristics, and LVEF in STEMI.

Main Methods:

  • Retrospective analysis of 52 first STEMI patients undergoing CMR.
  • LVH defined by left ventricular mass index (LVMI) exceeding 95th percentile.
  • Infarct size quantified by late gadolinium enhancement (LGE).

Main Results:

  • LVH identified in 31% of STEMI patients.
  • LVH patients exhibited significantly larger absolute and relative infarct mass.
  • LVH correlated with higher microvascular obstruction, myocardial hemorrhage, and transmural necrosis.

Conclusions:

  • STEMI patients with LVH have larger infarcts than those without LVH.
  • LVH can mask the true extent of myocardial damage as assessed by LVEF.
  • CMR is crucial for accurate infarct size assessment in STEMI patients with LVH.
Abstract

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