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Role of left ventricular dyssynchrony in predicting remodeling after ST elevation myocardial infarction

Burak Turan1, Fatih Yilmaz, Tansu Karaahmet

  • 1Cardiology Department, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey. drburakturan@gmail.com

Echocardiography (Mount Kisco, N.Y.)
|November 22, 2011
PubMed

Insights

Intraventricular dyssynchrony predicts left ventricular remodeling after myocardial infarction. Tissue Doppler imaging assessment of dyssynchrony can aid in risk stratification for patients post-STEMI.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Heart Failure Research

Background:

  • Intraventricular dyssynchrony is linked to reduced systolic function, adverse cardiac remodeling, and adverse clinical outcomes.
  • Left ventricular (LV) remodeling is a significant factor in post-myocardial infarction prognosis.

Purpose of the Study:

  • To determine if intraventricular dyssynchrony, measured by tissue Doppler imaging (TDI), can predict LV remodeling.
  • To assess the predictive value of TDI-derived dyssynchrony in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI).

Main Methods:

  • Fifty-two patients with first STEMI treated with pPCI were included.
  • Echocardiography with color-coded TDI was performed within 48 hours to assess LV dyssynchrony (Ts-diff).
  • LV remodeling was defined as a >15% increase in LV end-systolic volume index (LVESVI) after 6 months, with repeat echocardiography.

Main Results:

  • Twenty-three percent of patients (11/52) developed LV remodeling.
  • Baseline dyssynchrony (Ts-diff) correlated with changes in LVESVI and LVEDVI after 6 months.
  • Ts-diff was an independent predictor of remodeling, with Ts-diff >56 msec showing 72.7% sensitivity and 83.8% specificity.

Conclusions:

  • LV dyssynchrony is a robust predictor of LV remodeling following acute myocardial infarction (AMI).
  • TDI assessment of intraventricular dyssynchrony can be valuable for risk stratifying patients after AMI.
Abstract

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