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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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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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Increased left ventricular mass and decreased left ventricular systolic function have independent pathways to

Kyndaron Reinier1, Celia Dervan, Tejwant Singh

  • 1Heart Institute, Cedars-Sinai Medical Center, Los Angeles California, USA.

Heart Rhythm
|March 8, 2011
PubMed

Insights

Sudden cardiac death risk increases with both reduced left ventricular ejection fraction (LVSD) and increased left ventricular mass (LVH). These factors have independent and additive effects on risk, suggesting distinct underlying mechanisms.

Area of Science:

  • Cardiology
  • Sudden Cardiac Death Research
  • Cardiovascular Disease

Background:

  • Left ventricular systolic dysfunction (LVSD) and increased left ventricular (LV) mass vary significantly post-myocardial infarction.
  • Both LVSD and LV mass impact sudden cardiac death (SCD) risk, yet only LV ejection fraction is currently used for risk prediction.

Purpose of the Study:

  • To assess the independent and additive contributions of increased LV mass and decreased LV ejection fraction to SCD risk in the general population.

Main Methods:

  • Utilized data from the Oregon Sudden Unexpected Death Study (2002-2008), including 191 SCD cases and 203 controls.
  • Compared echocardiographic LV mass obtained prior to SCD and employed logistic regression to analyze relationships between SCD, LVSD, LV mass, and clinical variables.

Main Results:

  • Severe LVSD and left ventricular hypertrophy (LVH) were independently associated with increased SCD risk (OR 1.9 and 1.8, respectively).
  • Coexisting severe LVSD and LVH showed an additive effect on SCD risk (OR 3.5).
  • Increased age, atrial fibrillation/flutter, elevated creatinine, and diabetes also increased risk, while angiotensin receptor blockers attenuated risk.

Conclusions:

  • Reduced LV ejection fraction and increased LV mass independently and additively increase the risk of sudden death.
  • Findings suggest distinct mechanistic pathways for ventricular arrhythmias in LVSD and LVH, despite their overlap.
Abstract

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