Publication

Predictors of left ventricular remodeling after ST-elevation myocardial infarction

Hendriks, T., Hartman, M. H. T., Vlaar, P. J. J., Prakken, N. H. J., Ende, van der, Y. M. Y., Lexis, C. P. H., van Veldhuisen, D. J., van der Horst, I. C. C., Lipsic, E., Nijveldt, R. & van der Harst, P., Sep-2017, In : International Journal Of Cardiovascular Imaging. 33, 9, p. 1415-1423 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)1415-1423
Number of pages9
JournalInternational Journal Of Cardiovascular Imaging
Volume33
Issue number9
Early online date7-Apr-2017
Publication statusPublished - Sep-2017

    Keywords

  • Magnetic resonance imaging, Myocardial infarction, Left ventricular remodeling, Multivariable analysis, SEGMENT-ELEVATION, PROGNOSTIC IMPLICATIONS, CARDIOVASCULAR EVENTS, CLINICAL-IMPLICATIONS, CORONARY ANGIOPLASTY, SYSTOLIC DYSFUNCTION, EJECTION FRACTION, HEART-FAILURE, MASS, HYPERTROPHY
Related Datasets
  1. GIPS-III

    Harst, van der, P. (Creator), University of Groningen, 2017

    Dataset

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