Related Experiment Video
Updated: Oct 4, 2025
Histological Quantification of Chronic Myocardial Infarct in Rats
Published on: December 11, 2016
Predictors and prognostic impact of left ventricular ejection fraction trajectories in patients with ST-segment
Zhijun Lei1, Bingyu Li1, Bo Li1
1Department of Cardiology, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, 301 Middle Yanchang Road, Shanghai, 200072, China.
Insights
After ST-segment elevation myocardial infarction (STEMI), left ventricular ejection fraction (LVEF) can follow two distinct trajectories. Persistently reduced LVEF indicates a poor prognosis, while recovery suggests a neutral outcome.
Area of Science:
- Cardiology
- Clinical Medicine
- Biomedical Engineering
Background:
- Limited evidence exists on left ventricular ejection fraction (LVEF) changes post-ST-segment elevation myocardial infarction (STEMI).
- Understanding LVEF trajectories is crucial for predicting patient outcomes after STEMI.
Purpose of the Study:
- To identify distinct LVEF trajectories following STEMI.
- To explore predictors of these LVEF trajectories.
- To assess the association between LVEF trajectories and prognosis, including cardiovascular mortality and heart failure rehospitalization.
Main Methods:
- Retrospective observational study of STEMI patients.
- Latent class trajectory modeling used to identify LVEF trajectories in patients with baseline LVEF < 50%.
- Logistic regression and Cox proportional hazard models analyzed predictors and prognostic impact of LVEF trajectories.
Main Results:
- Two LVEF trajectories identified in patients with reduced baseline LVEF: recovered and persistently reduced.
- Higher baseline LVEF, lower peak troponin T, non-anterior MI, and lower heart rates predicted LVEF recovery.
- Persistently reduced LVEF significantly increased risks of cardiovascular mortality (HR 7.49) and heart failure rehospitalization (HR 3.54).
- Recovered LVEF showed no significant increase in adverse outcomes.
Conclusions:
- STEMI patients exhibit distinct LVEF recovery patterns.
- Persistently reduced LVEF post-STEMI is a strong predictor of poor cardiovascular outcomes.
- Baseline characteristics can predict the likelihood of LVEF recovery, aiding in risk stratification.
Background:
There is little evidence on left ventricular ejection fraction (LVEF) trajectories after ST-segment elevation myocardial infarction (STEMI).
Aim:
We aim to identify the LVEF trajectories after STEMI and explore their predictors and association with prognosis.
Methods:
This is a retrospective, observational study of STEMI patients. The LVEF trajectories were identified by the latent class trajectory model in patients with baseline LVEF < 50%. We used logistic regression analysis to investigate the predictors for LVEF trajectories. The Cox proportional hazard model was used to assess the impact of LVEF trajectories on prognosis. The primary outcomes were cardiovascular mortality and heart failure (HF) rehospitalization.
Results:
572 of 1179 patients presented with baseline normal LVEF (≥ 50%) and 607 with baseline reduced LVEF (< 50%). Two distinct LVEF trajectories were identified in patients with baseline reduced LVEF: recovered LVEF group and persistently reduced LVEF group. Higher baseline LVEF, lower peak troponin T, non-anterior MI, and lower heart rates were all found to be independently associated with LVEF recovery. After multivariate adjustments, patients with persistently reduced LVEF experienced an increased risk of cardiovascular mortality (HR 7.49, 95% CI 1.94-28.87, P = 0.003) and HF rehospitalization (HR 3.54, 95% CI 1.56-8.06 P = 0.003) compared to patients with baseline normal LVEF. Patients with recovered LVEF, on the other hand, showed no significant risk of cardiovascular mortality and HF rehospitalization.
Conclusion:
Our study indicated two distinct LVEF trajectories after STEMI and that the persistently reduced LVEF trajectory was related to poor prognosis. In addition, several baseline characteristics can predict LVEF recovery.
More Related Videos
09:05Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
08:19Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
Published on: July 12, 2022
Related Concept Videos
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:17Pathophysiology of Heart Failure