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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

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High-risk patients with mild-moderate left ventricular dysfunction after a previous myocardial infarction. A

Gianluca Di Bella1, Fausto Pizzino2, Giovanni Donato Aquaro3

  • 1CNR Institute of Clinical Physiology, Pisa, Italy; Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Messina, Italy.

International Journal of Cardiology
|August 1, 2017
PubMed

Insights

Combining cardiac MRI parameters like LGE, LV dilation, and WMSI helps identify patients with previous myocardial infarction (MI) and mild-moderate left ventricular (LV) dysfunction at high risk for cardiac events.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Prognosis in patients with previous myocardial infarction (MI) and mild-moderate (MM) left ventricular (LV) dysfunction is understudied.
  • Cardiac magnetic resonance (CMR) offers advanced imaging for LV assessment.

Purpose of the Study:

  • To evaluate if combining LV parameters from CMR improves risk stratification in post-MI patients with MM-LV dysfunction.
  • To compare the prognostic value of multiparametric CMR in MM-LV dysfunction versus severe LV dysfunction (S-LV-D).

Main Methods:

  • 418 patients with previous MI underwent CMR to quantify LVEF, volumes, wall motion score index (WMSI), and infarct extent (LGE).
  • Patients were categorized by LVEF: normal (>55%), MM-LV-D (30-55%), and S-LV-D (≤30%).
  • Cardiac events (death or defibrillator shocks) were tracked over a median of 39.7 months.

Main Results:

  • Cardiac events occurred in 17% of S-LV-D, 7.5% of MM-LV-D, and 0.8% of normal LV-EF patients.
  • In MM-LV-D patients, LGE >11.3%, dilated LV, and WMSI >1.59 were associated with adverse events.
  • The presence of these three CMR factors in MM-LV-D patients indicated a worse prognosis, similar to S-LV-D patients.

Conclusions:

  • A multiparametric CMR approach (LGE, LV dilation, WMSI) identifies high-risk post-MI patients with MM-LV-D.
  • This approach allows risk stratification comparable to patients with severe LV dysfunction.
  • Further multicenter studies are recommended to validate these findings.
Abstract

Keywords:
Cardiac magnetic resonanceLeft ventricular volumesPrevious myocardial infarctionScar tissueWall motion abnormalities

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