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Updated: May 24, 2026
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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Rethinking post-infarction remodelling: identification and validation of data-driven cardiac MRI phenotypes for risk
Jin-Yi Xiang1, Jingping Wu1, Yun Zhao1
1Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 PuJian Road, Pudong New Area, Shanghai 200127, China.
European Heart Journal. Cardiovascular Imaging
|May 23, 2026
Summary
New heart remodeling phenotypes after myocardial infarction offer better risk prediction than traditional methods. These distinct patterns, identified using cardiac MRI, help stratify patients for major adverse cardiovascular events and heart failure.
Area of Science:
- Cardiology
- Medical Imaging
- Data Science
Background:
- Conventional definitions of adverse left ventricular remodeling (ALVR) after ST-elevation myocardial infarction (STEMI) lack prognostic power.
- Existing methods based on ejection fraction and ventricular volume changes are insufficient for predicting outcomes.
Purpose of the Study:
- To identify novel, prognostically relevant post-STEMI remodeling phenotypes using a data-driven approach.
- To improve risk stratification for major adverse cardiovascular events (MACE) following STEMI.
Main Methods:
- Prospective longitudinal study with derivation (n=337) and validation (n=190) cohorts of STEMI patients.
- Cardiac magnetic resonance (CMR) imaging at <7 days and 6-month follow-up.
- Unsupervised clustering applied to baseline and longitudinal biventricular, biatrial, and infarct parameters.
Main Results:
- Three reproducible phenotypes identified: Low-Risk, Early Remodeling, and Atrial-dominant Remodeling.
- Both Early Remodeling and Atrial-dominant Remodeling phenotypes were associated with significantly higher MACE risk in validation cohort.
- Atrial-dominant phenotype linked to increased risk of heart failure hospitalization.
- Derived phenotypes improved MACE discrimination (C-index 0.755 vs 0.714) compared to conventional ALVR.
Conclusions:
- Identified three reproducible post-MI remodeling phenotypes with superior risk stratification capabilities.
- These phenotypes provide valuable insights into post-MI heart failure development.
- Data-driven phenotyping using CMR offers enhanced prognostic assessment over traditional ALVR criteria.
