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Impact of Left Ventricular Dyssynchrony Early on Left Ventricular Function After First Acute Myocardial Infarction
The impact of left ventricular (LV) dyssynchrony after acute myocardial infarction (AMI) on LV ejection fraction (EF) is unknown. One hundred twenty-nine patients with a first ST-elevation AMI (58 ± 11 years, 78% men) and QRS duration
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| Published in: | The American journal of cardiology 2010-02, Vol.105 (3), p.306-311 |
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| container_title | The American journal of cardiology |
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| creator | Nucifora, Gaetano, MD Bertini, Matteo, MD Marsan, Nina Ajmone, MD Delgado, Victoria, MD Scholte, Arthur J., MD Ng, Arnold C.T., BSc (Med), MBBS van Werkhoven, Jacob M., MSc Siebelink, Hans-Marc J., MD, PhD Holman, Eduard R., MD, PhD Schalij, Martin J., MD, PhD van der Wall, Ernst E., MD, PhD Bax, Jeroen J., MD, PhD |
| description | The impact of left ventricular (LV) dyssynchrony after acute myocardial infarction (AMI) on LV ejection fraction (EF) is unknown. One hundred twenty-nine patients with a first ST-elevation AMI (58 ± 11 years, 78% men) and QRS duration |
| doi_str_mv | 10.1016/j.amjcard.2009.09.028 |
| format | article |
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One hundred twenty-nine patients with a first ST-elevation AMI (58 ± 11 years, 78% men) and QRS duration <120 ms were included. All patients underwent primary percutaneous coronary intervention. Real-time 3-dimensional echocardiography and myocardial contrast echocardiography were performed to assess LV function, LV dyssynchrony, and infarct size. LV dyssynchrony was defined as the SD of the time to reach the minimum systolic volume for 16 LV segments, expressed in percent cardiac cycle (systolic dyssynchrony index [SDI]). Myocardial perfusion at myocardial contrast echocardiography was scored (1 = normal/homogenous; 2 = decreased/patchy; 3 = minimal/absent) using a 16-segment model; a myocardial perfusion index, expressing infarct size, was derived by summing segmental contrast scores and dividing by the number of segments. SDI in patients with AMI was 5.24 ± 2.23% compared to 2.02 ± 0.70% of controls (p <0.001). Patients with AMI and LVEF <45% had significantly higher SDI compared to patients with LVEF ≥45% (4.29 ± 1.44 vs 6.95 ± 2.40, p <0.001). At multivariate analysis, SDI was independently related to LVEF; in addition, the impact of SDI on LV systolic function was incremental to infarct size and anterior location of AMI (F change 16.9, p <0.001). In conclusion, LV synchronicity is significantly impaired soon after AMI. LV dyssynchrony is related to LVEF and has an additional detrimental effect on LV function, beyond infarct size and the anterior location of AMI.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2009.09.028</identifier><identifier>PMID: 20102940</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Algorithms ; Angioplasty ; Angioplasty, Balloon, Coronary ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - physiopathology ; Arrhythmias, Cardiac - therapy ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Case-Control Studies ; Clinical medicine ; Coronary heart disease ; Electrocardiography ; Female ; Heart ; Heart attacks ; Heart Conduction System - physiopathology ; Humans ; Male ; Medical research ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - diagnosis ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocarditis. Cardiomyopathies ; Treatment Outcome ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - therapy</subject><ispartof>The American journal of cardiology, 2010-02, Vol.105 (3), p.306-311</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Feb 1, 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-3a380b42dd16ea77ece794f6067ddf92de1c6c10f55bd6b184de233c11bb8e773</citedby><cites>FETCH-LOGICAL-c542t-3a380b42dd16ea77ece794f6067ddf92de1c6c10f55bd6b184de233c11bb8e773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22390667$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20102940$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nucifora, Gaetano, MD</creatorcontrib><creatorcontrib>Bertini, Matteo, MD</creatorcontrib><creatorcontrib>Marsan, Nina Ajmone, MD</creatorcontrib><creatorcontrib>Delgado, Victoria, MD</creatorcontrib><creatorcontrib>Scholte, Arthur J., MD</creatorcontrib><creatorcontrib>Ng, Arnold C.T., BSc (Med), MBBS</creatorcontrib><creatorcontrib>van Werkhoven, Jacob M., MSc</creatorcontrib><creatorcontrib>Siebelink, Hans-Marc J., MD, PhD</creatorcontrib><creatorcontrib>Holman, Eduard R., MD, PhD</creatorcontrib><creatorcontrib>Schalij, Martin J., MD, PhD</creatorcontrib><creatorcontrib>van der Wall, Ernst E., MD, PhD</creatorcontrib><creatorcontrib>Bax, Jeroen J., MD, PhD</creatorcontrib><title>Impact of Left Ventricular Dyssynchrony Early on Left Ventricular Function After First Acute Myocardial Infarction</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The impact of left ventricular (LV) dyssynchrony after acute myocardial infarction (AMI) on LV ejection fraction (EF) is unknown. One hundred twenty-nine patients with a first ST-elevation AMI (58 ± 11 years, 78% men) and QRS duration <120 ms were included. All patients underwent primary percutaneous coronary intervention. Real-time 3-dimensional echocardiography and myocardial contrast echocardiography were performed to assess LV function, LV dyssynchrony, and infarct size. LV dyssynchrony was defined as the SD of the time to reach the minimum systolic volume for 16 LV segments, expressed in percent cardiac cycle (systolic dyssynchrony index [SDI]). Myocardial perfusion at myocardial contrast echocardiography was scored (1 = normal/homogenous; 2 = decreased/patchy; 3 = minimal/absent) using a 16-segment model; a myocardial perfusion index, expressing infarct size, was derived by summing segmental contrast scores and dividing by the number of segments. SDI in patients with AMI was 5.24 ± 2.23% compared to 2.02 ± 0.70% of controls (p <0.001). Patients with AMI and LVEF <45% had significantly higher SDI compared to patients with LVEF ≥45% (4.29 ± 1.44 vs 6.95 ± 2.40, p <0.001). At multivariate analysis, SDI was independently related to LVEF; in addition, the impact of SDI on LV systolic function was incremental to infarct size and anterior location of AMI (F change 16.9, p <0.001). In conclusion, LV synchronicity is significantly impaired soon after AMI. LV dyssynchrony is related to LVEF and has an additional detrimental effect on LV function, beyond infarct size and the anterior location of AMI.</description><subject>Aged</subject><subject>Algorithms</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Arrhythmias, Cardiac - therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Case-Control Studies</subject><subject>Clinical medicine</subject><subject>Coronary heart disease</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Conduction System - physiopathology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocarditis. 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One hundred twenty-nine patients with a first ST-elevation AMI (58 ± 11 years, 78% men) and QRS duration <120 ms were included. All patients underwent primary percutaneous coronary intervention. Real-time 3-dimensional echocardiography and myocardial contrast echocardiography were performed to assess LV function, LV dyssynchrony, and infarct size. LV dyssynchrony was defined as the SD of the time to reach the minimum systolic volume for 16 LV segments, expressed in percent cardiac cycle (systolic dyssynchrony index [SDI]). Myocardial perfusion at myocardial contrast echocardiography was scored (1 = normal/homogenous; 2 = decreased/patchy; 3 = minimal/absent) using a 16-segment model; a myocardial perfusion index, expressing infarct size, was derived by summing segmental contrast scores and dividing by the number of segments. SDI in patients with AMI was 5.24 ± 2.23% compared to 2.02 ± 0.70% of controls (p <0.001). Patients with AMI and LVEF <45% had significantly higher SDI compared to patients with LVEF ≥45% (4.29 ± 1.44 vs 6.95 ± 2.40, p <0.001). At multivariate analysis, SDI was independently related to LVEF; in addition, the impact of SDI on LV systolic function was incremental to infarct size and anterior location of AMI (F change 16.9, p <0.001). In conclusion, LV synchronicity is significantly impaired soon after AMI. LV dyssynchrony is related to LVEF and has an additional detrimental effect on LV function, beyond infarct size and the anterior location of AMI.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20102940</pmid><doi>10.1016/j.amjcard.2009.09.028</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Algorithms Angioplasty Angioplasty, Balloon, Coronary Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - physiopathology Arrhythmias, Cardiac - therapy Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular Case-Control Studies Clinical medicine Coronary heart disease Electrocardiography Female Heart Heart attacks Heart Conduction System - physiopathology Humans Male Medical research Medical sciences Middle Aged Multivariate Analysis Myocardial Infarction - diagnosis Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocarditis. Cardiomyopathies Treatment Outcome Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - therapy |
| title | Impact of Left Ventricular Dyssynchrony Early on Left Ventricular Function After First Acute Myocardial Infarction |
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