Misalignment of diastolic haemodynamic forces after STEMI was independently associated with adverse left ventricular remodelling at 4 months (OR 1.1; 95% CI 1.01-1.2; P=0.04).
Observational (n=49)
Does misalignment of left ventricular haemodynamic forces predict adverse left ventricular remodelling in reperfused STEMI patients?
Misalignment of diastolic haemodynamic forces assessed by CMR at 1 week post-STEMI independently predicts adverse left ventricular remodeling at 4 months.
Odds Ratio: 1.1 (95% CI 1.01–1.2)
p-value: p=0.04
AIMS: Altered left ventricular (LV) haemodynamic forces (HDFs) have been associated with positive and negative remodelling after pathogenic or therapeutic events. We aimed to identify LV HDFs patterns associated with adverse LV remodelling (aLVr) in reperfused segment elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: Forty-nine acute STEMI patients underwent cardiac magnetic resonance (CMR) at 1 week (baseline) and after 4 months (follow-up). LV HDFs were computed at baseline from cine CMR long axis data sets, using a novel technique based on endocardial boundary tracking, both in apex-base (A-B) and latero-septal (L-S) directions. HDFs distribution was evaluated by L-S over A-B HDFs ratio (L-S/A-B HDFs ratio %). HDFs parameters were computed over the entire heartbeat, in systole and diastole. At baseline, aLVr patients had lower systolic L-S HDF (2.7 ± 0.9 vs. 3.6 ± 1%; P = 0.027) and higher diastolic L-S/A-B HDF ratio (28 ± 14 vs. 19 ± 6%; P = 0.03). At univariate logistic regression analysis, higher infarct size odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.1; P = 0.04, higher L-S/A-B HDFs ratio (OR 1.1; 95% CI 1.01-1.2; P = 0.05) and lower L-S HDFs (OR 0.41; 95% CI 0.2-0.9; P = 0.04) were associated with aLVr at follow-up. In the multivariable logistic regression analysis, diastolic L-S/A-B HDF ratio remained the only independent predictor of aLVr (OR 1.1; 95% CI 1.01-1.2; P = 0.04). CONCLUSIONS: Misalignment of diastolic haemodynamic forces after STEMI is associated with aLVr after 4 months.
Filomena et al. (Thu,) conducted a observational in Acute ST-segment elevation myocardial infarction (STEMI) (n=49). Misalignment of diastolic haemodynamic forces (higher L-S/A-B HDF ratio) was evaluated on Adverse left ventricular remodelling (aLVr) (OR 1.1, 95% CI 1.01-1.2, p=0.04). Misalignment of diastolic haemodynamic forces after STEMI was independently associated with adverse left ventricular remodelling at 4 months (OR 1.1; 95% CI 1.01-1.2; P=0.04).