Key Points
- Identify clinical, hemodynamic, echocardiographic, and radionuclide angiographic factors predicting late-phase left ventricular dilation over one year after a first anterior myocardial infarction.
- Evaluated 67 patients with a first acute Q-wave anterior myocardial infarction not treated with thrombolytic agents at 4–7 days post-symptom onset using echocardiography, hemodynamics, and radionuclide angiography.
- Repeated imaging at one-year follow-up in the 55 completing patients and applied multivariate stepwise linear regression to identify baseline predictors of 1-year left ventricular end-diastolic volume (LVEDV) and volume change.
- A multivariate model comprising baseline LVEDV, left ventricular end-diastolic pressure, global wall motion score, and a TIMI score of 0–1 predicted 84% of LVEDV at one-year follow-up.
- TIMI score 0–1, global wall motion score, number of vessels with ≥70% stenosis, and baseline transverse end-diastolic diameter (which was inversely correlated) accounted for 81% of the variation in LVEDV change from baseline.
Structured PICO
PPopulation67 patients with first Q-wave acute anterior myocardial infarction not treated with thrombolytic agents
OOutcomeLeft ventricular end-diastolic volume after 1 year and change from baselinesurrogate
Patency of the infarct-related artery and early left ventricular end-diastolic pressure are major determinants of late left ventricular dilation after an anterior myocardial infarction.