Temporal evolution of left ventricular dyssynchrony after myocardial infarction: relation with changes in left
Gaetano Nucifora1, Matteo Bertini, Nina Ajmone Marsan
1Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.
European Heart Journal. Cardiovascular Imaging
|May 9, 2012
Summary
Reducing left ventricular (LV) dyssynchrony after acute myocardial infarction (MI) significantly improves LV systolic function recovery. This study shows that decreased LV dyssynchrony is a key factor in the healing process post-MI.
Area of Science:
- Cardiology
- Echocardiography
- Myocardial Infarction Research
Background:
- The impact of temporal changes in left ventricular (LV) dyssynchrony on LV functional recovery following acute myocardial infarction (MI) is not fully understood.
- Investigating the dynamic evolution of LV synchronicity is crucial for understanding post-MI cardiac healing.
Purpose of the Study:
- To evaluate the temporal changes in LV synchronicity after acute MI.
- To explore the relationship between evolving LV systolic function and LV synchronicity post-MI.
Main Methods:
- Real-time three-dimensional echocardiography was used to assess LV dyssynchrony (SDI) and global systolic function in 193 patients with first acute MI.
- Measurements were taken 48 hours post-percutaneous coronary intervention and at a 6-month follow-up.
Main Results:
- A significant improvement in LV ejection fraction (LVEF) and a reduction in LV dyssynchrony (SDI) were observed at 6 months post-MI (P < 0.001 and P = 0.003, respectively).
- A strong correlation was found between the change in LVEF and the change in SDI (β = -0.63; P < 0.001).
- LV dyssynchrony change was identified as an independent factor associated with LVEF changes, significantly enhancing the predictive model's explanatory power (R(2) increased from 0.41 to 0.57).
Conclusions:
- LV synchronicity evolves over time after acute MI.
- Reduction in LV dyssynchrony is an independent determinant of LV functional recovery in patients post-MI.
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