Document Detail

Left ventricular remodeling and ventricular arrhythmias after myocardial infarction.
MedLine Citation:
PMID:  12732606     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The relation between left ventricular (LV) remodeling and ventricular arrhythmias after myocardial infarction is poorly documented. We investigated the relations between LV size, hypertrophy, and function and ventricular arrhythmias in 263 patients from the Survival and Ventricular Enlargement (SAVE) study, using quantitative 2D echocardiography and ambulatory ECG monitoring after myocardial infarction. METHODS AND RESULTS: Transthoracic 2D echocardiograms and arrhythmia monitoring were performed at baseline (mean, 11 days) and 1 and 2 years after infarction. LV size, short-axis muscle (mass) area (LVMA), and function were quantified from 2D echocardiograms. The prevalence of ventricular tachycardia (VT) and frequent ventricular ectopy (premature ventricular contractions [PVCs] >10/h) was assessed from ambulatory ECG. VT and PVCs >10/h occurred in 20% and 29% of patients at baseline, in 22% and 35% at 1 year and 23% and 39% at 2 years, respectively. VT and PVCs >10/h at baseline and 1 and 2 years were significantly related to LV size, LVMA, and function. Furthermore, changes in LV size and function from baseline to 2 years predicted both VT and PVCs >10/h. The study was underpowered to detect treatment effect of ACE inhibitors and beta-adrenergic receptor blockers but did not alter the relations between ventricular arrhythmias, LV size, and function. CONCLUSIONS: Quantitative echocardiographic assessment of LV size, LVMA, and function and changes in these measurements over time predict ventricular arrhythmias after infarction. Altered LV architecture and function during postinfarction LV remodeling provide an important substrate for triggering high-grade ventricular arrhythmias.
Martin St John Sutton; Douglas Lee; Jean Lucien Rouleau; Steven Goldman; Ted Plappert; Eugene Braunwald; Marc A Pfeffer
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2003-05-05
Journal Detail:
Title:  Circulation     Volume:  107     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-06-02     Completed Date:  2003-06-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2577-82     Citation Subset:  AIM; IM    
Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Anti-Arrhythmia Agents / therapeutic use
Captopril / therapeutic use
Cardiomegaly / complications,  drug therapy
Double-Blind Method
Electrocardiography / drug effects
Electrocardiography, Ambulatory
Follow-Up Studies
Middle Aged
Multivariate Analysis
Myocardial Infarction / complications,  drug therapy*,  ultrasonography
Stroke Volume / drug effects
Tachycardia, Ventricular / complications,  diagnosis,  drug therapy*
Treatment Outcome
Ventricular Dysfunction, Left / complications,  drug therapy*,  ultrasonography
Ventricular Premature Complexes / complications,  diagnosis,  drug therapy*
Ventricular Remodeling / drug effects*
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Anti-Arrhythmia Agents; 62571-86-2/Captopril
Comment In:
Circulation. 2003 May 27;107(20):2531-2   [PMID:  12777316 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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