Predictors of left ventricular remodeling after ST-elevation myocardial infarction

Tom Hendriks, Minke H T Hartman, Pieter J J Vlaar, Niek H J Prakken, Yldau M. Y. Ende, van der, Chris P H Lexis, Dirk J van Veldhuisen, Iwan C C van der Horst, Erik Lipsic, Robin Nijveldt, Pim van der Harst*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

13 Citaten (Scopus)
267 Downloads (Pure)

Samenvatting

Adverse left ventricular (LV) remodeling after acute ST-elevation myocardial infarction (STEMI) is associated with morbidity and mortality. We studied clinical, biochemical and angiographic determinants of LV end diastolic volume index (LVEDVi), end systolic volume index (LVESVi) and mass index (LVMi) as global LV remodeling parameters 4 months after STEMI, as well as end diastolic wall thickness (EDWT) and end systolic wall thickness (ESWT) of the non-infarcted myocardium, as compensatory remote LV remodeling parameters. Data was collected in 271 patients participating in the GIPS-III trial, presenting with a first STEMI. Laboratory measures were collected at baseline, 2 weeks, and 6-8 weeks. Cardiovascular magnetic resonance imaging (CMR) was performed 4 months after STEMI. Linear regression analyses were performed to determine predictors. At baseline, patients were 21% female, median age was 58 years. At 4 months, mean LV ejection fraction (LVEF) was 54 +/- 9%, mean infarct size was 9.0 +/- 7.9% of LVM. Strongest univariate predictors (all p <0.001) were peak Troponin T for LVEDVi (R-2 = 0.26), peak CK-MB for LVESVi (R-2 = 0.41), NT-proBNP at 2 weeks for LVMi (R-2 = 0.24), body surface area for EDWT (R-2 = 0.32), and weight for ESWT (R-2 = 0.29). After multivariable analysis, cardiac biomarkers remained the strongest predictors of LVMi, LVEDVi and LVESVi. NT-proBNP but none of the acute cardiac injury biomarkers were associated with remote LV wall thickness. Our analyses illustrate the value of cardiac specific biochemical biomarkers in predicting global LV remodeling after STEMI. We found no evidence for a hypertrophic response of the non-infarcted myocardium.

Originele taal-2English
Pagina's (van-tot)1415-1423
Aantal pagina's9
TijdschriftInternational Journal Of Cardiovascular Imaging
Volume33
Nummer van het tijdschrift9
Vroegere onlinedatum7-apr-2017
DOI's
StatusPublished - sep-2017

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