Late-diastolic left ventricular blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling of at least 15% and 20% (p < 0.01).
Cohort (n=69)
Does left ventricular blood flow kinetic energy measured by 4D flow CMR early after STEMI predict adverse LV remodeling at 3 months?
Late-diastolic LV blood flow kinetic energetics measured by 4D flow CMR early after acute STEMI is independently associated with adverse LV remodeling at 3 months.
valor p: p=<0.01
BACKGROUND: Myocardial infarction leads to complex changes in left ventricular (LV) hemodynamics. It remains unknown how four-dimensional acute changes in LV-cavity blood flow kinetic energy affects LV-remodeling. METHODS AND RESULTS: In total, 69 revascularised ST-segment elevation myocardial infarction (STEMI) patients were enrolled. All patients underwent cardiovascular magnetic resonance (CMR) examination within 2 days of the index event and at 3-month. CMR examination included cine, late gadolinium enhancement, and whole-heart four-dimensional flow acquisitions. LV volume-function, infarct size (indexed to body surface area), microvascular obstruction, mitral inflow, and blood flow KEi (kinetic energy indexed to end-diastolic volume) characteristics were obtained. Adverse LV-remodeling was defined and categorized according to increase in LV end-diastolic volume of at least 10%, 15%, and 20%. Twenty-four patients (35%) developed at least 10%, 17 patients (25%) at least 15%, 11 patients (16%) at least 20% LV-remodeling. Demographics and clinical history were comparable between patients with/without LV-remodeling. In univariable regression-analysis, A-wave KEi was associated with at least 10%, 15%, and 20% LV-remodeling (p = 0.03, p = 0.02, p = 0.02, respectively), whereas infarct size only with at least 10% LV-remodeling (p = 0.02). In multivariable regression-analysis, A-wave KEi was identified as an independent marker for at least 10%, 15%, and 20% LV-remodeling (p = 0.09, p < 0.01, p < 0.01, respectively), yet infarct size only for at least 10% LV-remodeling (p = 0.03). CONCLUSION: In patients with STEMI, LV hemodynamic assessment by LV blood flow kinetic energetics demonstrates a significant inverse association with adverse LV-remodeling. Late-diastolic LV blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling.
Demirkıran et al. (Mon,) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=69). Four-dimensional flow cardiovascular magnetic resonance (A-wave KEi) was evaluated on Adverse LV-remodeling (increase in LV end-diastolic volume ≥10%, ≥15%, and ≥20%) (p=<0.01). Late-diastolic left ventricular blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling of at least 15% and 20% (p < 0.01).
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