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Article: Left ventricular systolic dyssynchrony is a predictor of cardiac remodeling after myocardial infarction

TitleLeft ventricular systolic dyssynchrony is a predictor of cardiac remodeling after myocardial infarction
Authors
Issue Date2008
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ahj
Citation
American Heart Journal, 2008, v. 156 n. 6, p. 1124-1132 How to Cite?
AbstractObjectives: We sought to determine whether early assessment of left ventricular (LV) dyssynchrony by tissue Doppler imaging may predict progressive ventricular enlargement and cardiac dysfunction after acute myocardial infarction (MI). Methods: Forty-seven patients (mean age 59.9 ± 11.6 years) with normal QRS duration underwent tissue Doppler imaging and contrast-enhanced cardiac magnetic resonance imaging (Ce-MRI) at days 2 to 6, 3 months, and at 1 year after the index MI. Systolic dyssynchrony index (Ts-SD) was calculated from 12 LV segments, and infarct size (IS) by Ce-MRI. Results: The remodeling group (n = 16) (defined as an increase in end-systolic volume ≥10% between 1 year and baseline) had greater initial IS (27.2 ± 9.6 vs 13.7 ± 4.1%, P < .001) and Ts-SD (50.9 ± 12.8 vs 33.6 ± 7.7 milliseconds, P < .001) than nonremodeling group (n = 31). At 1 year, the remodeling group had progressive increase in Ts-SD and decrease in LV ejection fraction (57.3 ± 18.5 and 36.0 ± 7.6%, respectively; both P < .05 vs baseline). Both Ts-SD (odds ratio 1.19 [1.07-1.32], P = .001) and IS (odds ratio 1.65 [1.19-2.29], P = .003) were shown to be independent predictors of progressive LV remodeling. A cutoff value of Ts-SD ≥45 milliseconds predicted LV remodeling at 1 year (sensitivity 90.5%, specificity 90.9%, Area-under-curve 0.907) (P = .0005). Conclusions: Left ventricular systolic dyssynchrony is a newly identified predictor of chronic LV remodeling after acute MI, which is independent and incremental to conventional assessment and IS as measured by Ce-MRI. © 2008 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/163213
ISSN
2015 Impact Factor: 4.332
2015 SCImago Journal Rankings: 3.157
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorZhang, Yen_US
dc.contributor.authorYip, GWen_US
dc.contributor.authorChan, AKYen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorLam, WWMen_US
dc.contributor.authorFung, JWHen_US
dc.contributor.authorChan, JYSen_US
dc.contributor.authorSanderson, JEen_US
dc.contributor.authorYu, CMen_US
dc.date.accessioned2012-09-05T05:28:47Z-
dc.date.available2012-09-05T05:28:47Z-
dc.date.issued2008en_US
dc.identifier.citationAmerican Heart Journal, 2008, v. 156 n. 6, p. 1124-1132en_US
dc.identifier.issn0002-8703en_US
dc.identifier.urihttp://hdl.handle.net/10722/163213-
dc.description.abstractObjectives: We sought to determine whether early assessment of left ventricular (LV) dyssynchrony by tissue Doppler imaging may predict progressive ventricular enlargement and cardiac dysfunction after acute myocardial infarction (MI). Methods: Forty-seven patients (mean age 59.9 ± 11.6 years) with normal QRS duration underwent tissue Doppler imaging and contrast-enhanced cardiac magnetic resonance imaging (Ce-MRI) at days 2 to 6, 3 months, and at 1 year after the index MI. Systolic dyssynchrony index (Ts-SD) was calculated from 12 LV segments, and infarct size (IS) by Ce-MRI. Results: The remodeling group (n = 16) (defined as an increase in end-systolic volume ≥10% between 1 year and baseline) had greater initial IS (27.2 ± 9.6 vs 13.7 ± 4.1%, P < .001) and Ts-SD (50.9 ± 12.8 vs 33.6 ± 7.7 milliseconds, P < .001) than nonremodeling group (n = 31). At 1 year, the remodeling group had progressive increase in Ts-SD and decrease in LV ejection fraction (57.3 ± 18.5 and 36.0 ± 7.6%, respectively; both P < .05 vs baseline). Both Ts-SD (odds ratio 1.19 [1.07-1.32], P = .001) and IS (odds ratio 1.65 [1.19-2.29], P = .003) were shown to be independent predictors of progressive LV remodeling. A cutoff value of Ts-SD ≥45 milliseconds predicted LV remodeling at 1 year (sensitivity 90.5%, specificity 90.9%, Area-under-curve 0.907) (P = .0005). Conclusions: Left ventricular systolic dyssynchrony is a newly identified predictor of chronic LV remodeling after acute MI, which is independent and incremental to conventional assessment and IS as measured by Ce-MRI. © 2008 Elsevier Inc. All rights reserved.en_US
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ahjen_US
dc.relation.ispartofAmerican Heart Journalen_US
dc.subject.meshAgeden_US
dc.subject.meshCardiac Volume - Physiologyen_US
dc.subject.meshEchocardiography, Doppler, Coloren_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshImage Enhancementen_US
dc.subject.meshImage Processing, Computer-Assisteden_US
dc.subject.meshMagnetic Resonance Imaging, Cineen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Contraction - Physiologyen_US
dc.subject.meshMyocardial Infarction - Physiopathology - Ultrasonographyen_US
dc.subject.meshSensitivity And Specificityen_US
dc.subject.meshStroke Volume - Physiologyen_US
dc.subject.meshSystole - Physiologyen_US
dc.subject.meshVentricular Dysfunction, Left - Physiopathology - Ultrasonographyen_US
dc.subject.meshVentricular Remodeling - Physiologyen_US
dc.titleLeft ventricular systolic dyssynchrony is a predictor of cardiac remodeling after myocardial infarctionen_US
dc.typeArticleen_US
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_US
dc.identifier.authorityWang, M=rp00281en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.ahj.2008.07.019en_US
dc.identifier.pmid19033008-
dc.identifier.scopuseid_2-s2.0-56349148313en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-56349148313&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume156en_US
dc.identifier.issue6en_US
dc.identifier.spage1124en_US
dc.identifier.epage1132en_US
dc.identifier.isiWOS:000261484500015-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridZhang, Y=36067269500en_US
dc.identifier.scopusauthoridYip, GW=7006525328en_US
dc.identifier.scopusauthoridChan, AKY=7403168116en_US
dc.identifier.scopusauthoridWang, M=7406690398en_US
dc.identifier.scopusauthoridLam, WWM=13410486800en_US
dc.identifier.scopusauthoridFung, JWH=7203073343en_US
dc.identifier.scopusauthoridChan, JYS=26664291200en_US
dc.identifier.scopusauthoridSanderson, JE=7202371250en_US
dc.identifier.scopusauthoridYu, CM=7404976646en_US

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