Usefulness of Left Ventricular Dyssynchrony After Acute Myocardial Infarction, Assessed by a Tagging Magnetic Resonance Image Derived Metric, as a Determinant of Ventricular Remodeling

• Published in: The American journal of cardiology 2009-07, Vol.104 (1), p.19-23
• Main Authors: Chang, Sung-A., MD, Chang, Hyuk-Jae, MD, Choi, Sang Il, MD, Chun, Eun Ju, MD, Yoon, Yeonyee E., MD, Kim, Hyung-Kwan, MD, Kim, Yong-Jin, MD, Choi, Dong-Ju, MD, Sohn, Dae-Won, MD, Helm, Robert H., MD, Lardo, Albert C., PhD
• Format: Article
• Language: English
• Subjects: Acute Disease; Angioplasty, Balloon, Coronary; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - physiopathology; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Comparative analysis; Coronary heart disease; Correlation analysis; Female; Heart; Heart attacks; Humans; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Magnetic Resonance Imaging; Male; Medical sciences; Medical treatment; Middle Aged; Multivariate Analysis; Myocardial Infarction - pathology; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; NMR; Nuclear magnetic resonance; Prospective Studies; Statistics as Topic; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology; Ventricular Remodeling
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.02.042

Development of left ventricular (LV) remodeling after acute myocardial infarction (AMI) is a serious medical complication. We investigated the correlation of LV dyssynchrony after AMI with LV remodeling using magnetic resonance–myocardial tagging (MR-MT) derived dyssynchrony index (circumferential uniformity ratio estimate [CURE]). Forty-three patients diagnosed with ST-elevation AMI were analyzed. After treatment with primary percutaneous intervention, cardiac magnetic resonance imaging was performed to obtain a cine image, a delayed enhancement image, and an MR-MT image. CURE as a dyssynchrony index was calculated from the MR-MT image using HARP software (CURE 0 to 1 = dyssynchrony to synchrony). After 6 months, follow-up cardiac magnetic resonance imaging was performed to assess degree of LV remodeling. Sixteen patients (37%) had an increased LV end-systolic volume (ESV) >15% compared with baseline. The baseline LV dyssynchrony index, CURE, was significantly associated with ESV at 6 months (r = −0.49, p 75%, n = 31) showed that this correlation was stronger (beta −0.52, p = 0.006), suggesting that CURE could predict progression of LV remodeling in patients with AMI and nonviable myocardium. LV dyssynchrony immediately after AMI is an important determinant of LV remodeling. In conclusion, the MR-MT dyssynchrony index, CURE, might be useful for prediction of LV remodeling in patients with AMI.