Predictive value of early left ventricular end-diastolic volume changes for late left ventricular remodeling after ST-elevation myocardial infarction

Figures

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  Figure 1. Study flow chart. Flow chart showing inclusion and exclusion criteria; STEMI — ST-segment elevation myocardial infarction.

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  Figure 2. Echocardiography parameters: 1 day (1d) after percutaneous coronary intervention to 6 months (6m) post-discharge. Changes in left ventricular end-diastolic volume (LVEDV) (A), left ventricular ejection fraction (LVEF) (B) and left ventricular end-systolic volume (LVESV) (D) during 6 months of follow-up in the left ventricular remodeling (LVR) and non-LVR (n-LVR) groups. Comparison of LVEDV changes at different times (C); *p < 0.05 between LVEDV in LVR and n-LVR groups; **p < 0.05 between LVEF in LVR and n-LVR groups; ***p < 0.001 between LVEDV rate of change in LVR and n-LVR groups; ****p < 0.05 between LVESV in LVR and n-LVR groups; #p < 0.05 within LVR groups; ##p < 0.05 within n-LVR groups. ΔLVEDV%1 — increase in LVEDV from the first day after PCI to discharge; ΔLVEDV%2 — increase in LVEDV from discharge to 1 month after discharge; ΔLVEDV%3 — increase in LVEDV from 1 month to 6 months post-discharge; ΔLVEDV%4 — increase in LVEDV from discharge to 6 months post-discharge.

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  Figure 3. Relationship between ΔLVEDV% and late left ventricular remodeling (LVR). Multiple logistic regression analysis for predicting LVR (A). Receiver operating characteristic curve for risk prediction of LVR (B). Sensitivity and specificity were maximized at 0.68 and 0.57, respectively in Model 1 (peak CK-MB, cutoff value = 177.2 U/L, p = 0.001). Sensitivity and specificity were maximized at 0.46 and 0.86, respectively in Model 2 (ΔLVEDV%1, cutoff value = 3.09%. p < 0.0001). Sensitivity and specificity were maximized at 0.75 and 0.72, respectively in Model 3 (ΔLVEDV%2, cutoff value = 4.53%. p < 0.0001). Sensitivity and specificity were maximized at 0.81 and 0.73, respectively in Model 4 (ΔLVEDV%1 and ΔLVEDV%2, p < 0.0001). Sensitivity and specificity were maximized at 0.78 and 0.81, respectively in Model 5 (peak CK-MB, ΔLVEDV%1 and ΔLVEDV%2, p < 0.0001). Model 4 and Model 5 showed no significant difference in predictive power for late LVR (p = 0.071). Model 6 included Model 5 and left ventricular ejection fraction (LVEF) at 1 month, Model 7 incorporated all variables in multiple logistic regression analysis. Model 8 included Model 7 and age (p < 0.001 in these 3 models); OR — odds…