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Left ventricular function recovery after ST-elevation myocardial infarction: correlates and outcomes

Jeroen Dauw1,2, Pieter Martens3, Sébastien Deferm3,4

  • 1Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium. jeroen.dauw@zol.be.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|June 6, 2021
PubMed

Insights

Left ventricular function recovery after ST-elevation myocardial infarction (STEMI) is crucial. Persistently reduced function significantly worsens prognosis compared to normal or recovered function.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Heart Disease Research

Background:

  • Limited contemporary data exist on left ventricular function (LVF) recovery post-ST-elevation myocardial infarction (STEMI).
  • No prior studies have compared LVF recovery outcomes with patients who had normal baseline LVF.

Purpose of the Study:

  • To identify predictors of LVF recovery in STEMI patients.
  • To compare outcomes (heart failure hospitalization, mortality) between patients with baseline normal LVF, recovered LVF, and persistently reduced LVF.

Main Methods:

  • Patients with STEMI (2010-2016) were grouped by LVF (ejection fraction [EF]) at 3 months: baseline normal (EF ≥ 50%), recovered (EF < 50% to ≥ 50%), and reduced (EF < 50%).
  • Outcomes including heart failure hospitalization and mortality were compared across the three groups.

Main Results:

  • Of 577 patients, 59% had baseline normal LVF, 19% recovered LVF, and 22% had reduced LVF.
  • Higher baseline EF, lower peak troponin, and cardiac arrest were predictors of LVF recovery.
  • No outcome difference was observed between recovered LVF and baseline normal LVF groups.
  • Persistently reduced LVF was associated with significantly higher risks of heart failure hospitalization (HR 5.00) and all-cause mortality (HR 1.87).

Conclusions:

  • Persistently reduced LVF 3 months post-STEMI indicates a significantly worse prognosis.
  • LVF recovery in STEMI patients leads to outcomes comparable to those with normal baseline LVF.
  • Early identification and management of factors influencing LVF recovery are critical for improving STEMI patient outcomes.
Abstract

Keywords:
Ejection fraction recoveryHeart failure hospitalizationLeft ventricular systolic dysfunctionMortalityST-elevation myocardial infarction

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