Relation of initial infarct size to extent of left ventricular remodeling in the year after acute myocardial infarction
Key result
Discharge infarct size strongly correlates with 1-year declines in LVEF and adverse LV remodeling.
- r = 0.63 (end-systolic volume); r = -0.66 (ejection fraction)
- P=0.02 (end-systolic volume); p = 0.01 (ejection fraction)
- n=14
Why the study?
Clinical studies have not clearly replicated the animal study findings that left ventricular remodeling after myocardial infarction is linearly related to infarct size due to imprecise measurements and lack of adjustment for infarct-related artery patency.
Does initial infarct size measured by Tc-99m sestamibi predict left ventricular remodeling over 1 year in patients with acute myocardial infarction and patent infarct-related arteries?
Population
14 patients after acute myocardial infarction with documented infarct-related artery patency
Comparison
Relation of infarct size to left ventricular remodeling measures
Design
Prospective observational study with Tc-99m sestamibi and electron beam CT imaging
Follow-up
1 year
Authors
Discussion
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Implication
Initial infarct size measured by Tc-99m sestamibi at hospital discharge strongly predicts the extent of left ventricular dilation and dysfunction over the subsequent year in patients with patent infarct-related arteries.
Key Points
- To evaluate the relationship between initial myocardial infarct size and the progression of left ventricular remodeling during the first year after acute myocardial infarction.
- Measured baseline myocardial infarct size following acute myocardial infarction.
- Tracked left ventricular dimensions, volume, and structural remodeling over a one-year follow-up period.
- Greater initial infarct size significantly associates with progressive left ventricular dilation and adverse remodeling over one year.
- Patients with smaller initial infarcts demonstrate minimal ventricular enlargement and better preservation of cardiac geometry.
Study Design
Type
Cohort (n=14)
Structured PICO
Does initial infarct size measured by Tc-99m sestamibi predict left ventricular remodeling over 1 year in patients with acute myocardial infarction and patent infarct-related arteries?
P
Population
14 patients with acute myocardial infarction and documented infarct-related artery patency after reperfusion therapy, followed for 1 year.
E
Exposure
Measurement of infarct size by technetium-99m (Tc-99m) sestamibi perfusion imaging at hospital discharge.
O
Outcome
Left ventricular remodeling (absolute end-systolic volume, end-diastolic volume, and ejection fraction) measured by electron beam computed tomography at 1 year.surrogate
Main Result
Effect estimate: r = 0.63 (end-systolic volume); r = -0.66 (ejection fraction)
p-value: p = 0.02 (end-systolic volume); p = 0.01 (ejection fraction)
Initial infarct size measured by Tc-99m sestamibi at hospital discharge strongly predicts the extent of left ventricular dilation and dysfunction over the subsequent year in patients with patent infarct-related arteries.
Cite This Study
Chareonthaitawee et al. (1995) conducted a cohort in acute myocardial infarction (n=14). Infarct size was evaluated on Changes in end-systolic volume and ejection fraction over 1 year (r = 0.63 (end-systolic volume); r = -0.66 (ejection fraction), p=p = 0.02 (end-systolic volume); p = 0.01 (ejection fraction)). Infarct size at discharge was significantly correlated with subsequent changes over 1 year in end-systolic volume (r=0.63, p=0.02) and ejection fraction (r=-0.66, p=0.01).