Left ventricular remodeling after acute myocardial infarction

Recognition of the time course of LV remodeling following acute myocardial infarction is essential for instituting timely pharmacologic therapy aimed at altering its adverse effects. In the present study, we prospectively examined the time course of LV remodeling in 468 (287 Caucasian and 181 African-American) patients after a first acute myocardial infarction. Two-dimensional echocardiograms were obtained in all patients within 48 hours of hospital admission (baseline), and at 3 months and 6 months after discharge. Echocardiograms were used to calculate LV end-systolic (ESVI) and end-diastolic (EDVI) volume indexes, and end-diastolic sphericity index (EDSI) defined as the ratio of LV major-to-minor axis at end-diastole. (See Table) = P < 0.001 Baseline vs. 3 months: = P < 0.02 3 Months vs. 6 months = P < 0.001 Baseline vs. 3 months: = P < 0.02 3 Months vs. 6 months The results indicate that the significant changes in EDVI, ESVI, and EDSI occur between the baseline and 3 months and only minimal between 3 and 6 months after first acute myocardial infarction. There were similar changes in these parameters between Caucasian and African-American patients. LV remodeling, evidenced by an increase in LV size and chamber sphericity is similar in both races and takes place predominantly in the first 3 months after a first acute myocardial infarction. Further remodeling between 3 and 6 months, if any, is small.