Key result
A composite dyssynchrony score independently predicted a persistently dilated left ventricle and low ejection fraction at 1-year follow-up in 100 patients with NSTEMI.
Why the study?
Does early left ventricular dyssynchrony predict long-term LV dysfunction in patients after NSTEMI without congestive heart failure?
Cohort (n=100)
Does early left ventricular dyssynchrony predict long-term LV dysfunction in patients after NSTEMI without congestive heart failure?
Early assessment of LV dyssynchrony using a composite score after NSTEMI helps identify patients at risk for persistently dilated and impaired left ventricle at 1 year.
May identify NSTEMI patients at risk for persistent LV dysfunction; hypothesis-generating and requires prospective validation before clinical use.
AIMS: To determine independent predictors of left ventricular (LV) dyssynchrony after non-ST elevation myocardial infarction (NSTEMI) and prognostic value of combining dyssynchrony parameters for long-term LV dysfunction. METHODS AND RESULTS: Left ventricular dyssynchrony assessments were performed in 100 NSTEMI patients followed-up for 1 year using a composite dyssynchrony score. Early LV dyssynchrony was independently predicted by the presence of significant proximal left circumflex artery (LCx) stenosis and global systolic dysfunction. Left ventricular end-diastolic volume index decreased with time and was independently determined by a lower number of diseased vessels and the absence of early dyssynchrony. Left ventricular end-systolic volume index decreased with time and was independently determined by the absence of early dyssynchrony, lower number of diseased vessels, and revascularization. Left ventricular ejection fraction increased with time and was independently determined by the absence of early dyssynchrony, lower number of diseased vessels, and revascularization. The composite dyssynchrony score was an independent determinant of a persistently dilated LV and low LVEF at follow-up. CONCLUSION: After NSTEMI, proximal LCx stenosis and impaired LV function independently predicted LV dyssynchrony. The composite dyssynchrony score had prognostic value and identified patients with persistently dilated and impaired LV on follow-up.
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Ng et al. (2009) conducted a cohort in Non-ST elevation myocardial infarction (NSTEMI) without congestive heart failure (n=100). Composite dyssynchrony score (early LV dyssynchrony) vs. Absence of early dyssynchrony was evaluated on Long-term LV dysfunction (persistently dilated LV and low LVEF). A composite dyssynchrony score independently predicted a persistently dilated left ventricle and low ejection fraction at 1-year follow-up in 100 patients with NSTEMI.
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