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Association between discharge heart rate and left ventricular adverse remodelling in ST segment elevation myocardial

Emer Joyce1, Georgette E Hoogslag, Darryl P Leong

  • 1Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.

Heart (British Cardiac Society)
|March 8, 2013
PubMed

Insights

Discharge heart rate (DHR) is linked to left ventricular (LV) remodelling after ST-elevation myocardial infarction (STEMI). Higher DHR predicts adverse LV remodelling, highlighting its role as an early risk marker.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Clinical Medicine

Background:

  • Left ventricular (LV) adverse remodelling is a significant predictor of mortality post-ST-elevation myocardial infarction (STEMI).
  • Discharge heart rate (DHR) has emerged as a potential indicator of long-term outcomes following STEMI.
  • The relationship between DHR and the development of LV remodelling after STEMI has not been previously established.

Purpose of the Study:

  • To investigate the association between discharge heart rate (DHR) and the occurrence of left ventricular (LV) remodelling at 6 months post-STEMI.
  • To identify early risk markers for adverse LV remodelling in patients recovering from STEMI.

Main Methods:

  • A cohort of 964 patients with STEMI treated with primary percutaneous coronary intervention were analyzed.
  • Discharge heart rate (DHR) was determined from predischarge electrocardiograms.
  • Left ventricular (LV) volumes were assessed using echocardiography at baseline and 6-month follow-up to define LV remodelling (≥20% increase in LV end-diastolic volume).

Main Results:

  • Left ventricular (LV) remodelling occurred in 30.7% of patients.
  • Patients with LV remodelling exhibited significantly higher DHR (72±11 bpm vs. 68±12 bpm, p<0.001).
  • Discharge heart rate (DHR) >69 bpm (OR 1.5, p=0.01) and elevated peak troponin T were independently associated with LV remodelling.

Conclusions:

  • Discharge heart rate (DHR) is an independent predictor of left ventricular (LV) remodelling after ST-elevation myocardial infarction (STEMI).
  • Heart rate measured at discharge serves as a valuable early risk marker for adverse LV remodelling in STEMI patients.
Abstract

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