Document Detail

Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling.
MedLine Citation:
PMID:  20478987     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left ventricular (LV) torsion is emerging as a sensitive parameter of LV systolic myocardial performance. The aim of the present study was to explore the effects of acute myocardial infarction (AMI) on LV torsion and to determine the value of LV torsion early after AMI in predicting LV remodeling at 6-month follow-up.
METHODS AND RESULTS: A total of 120 patients with a first ST-segment elevation AMI (mean+/-SD age, 59+/-10 years; 73% male) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, speckle-tracking echocardiography was performed to assess LV torsion; infarct size was assessed by myocardial contrast echocardiography. At 6-month follow-up, LV volumes and LV ejection fraction were reassessed to identity patients with LV remodeling (defined as a > or =15% increase in LV end-systolic volume). Compared with control subjects, peak LV torsion in AMI patients was significantly impaired (1.54+/-0.64 degrees /cm vs 2.07+/-0.27 degrees /cm, P<0.001). By multivariate analysis, only LV ejection fraction (beta=0.36, P<0.001) and infarct size (beta=-0.47, P<0.001) were independently associated with peak LV torsion. At 6-month follow-up, 19 patients showed LV remodeling. By multivariate analysis, only peak LV torsion (odds ratio=0.77; 95% CI, 0.65-0.92; P=0.003) and infarct size (odds ratio=1.04; 95% CI, 1.01-1.07; P=0.021) were independently related to LV remodeling. Peak LV torsion provided modest but significant incremental value over clinical, echocardiographic, and myocardial contrast echocardiography variables in predicting LV remodeling. By receiver-operating characteristics curve analysis, peak LV torsion < or =1.44 degrees /cm provided the highest sensitivity (95%) and specificity (77%) to predict LV remodeling.
CONCLUSIONS: LV torsion is significantly impaired early after AMI. The amount of impairment of LV torsion predicts LV remodeling at 6-month follow-up.
Gaetano Nucifora; Nina Ajmone Marsan; Matteo Bertini; Victoria Delgado; Hans-Marc J Siebelink; Jacob M van Werkhoven; Arthur J Scholte; Martin J Schalij; Ernst E van der Wall; Eduard R Holman; Jeroen J Bax
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-17
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-21     Completed Date:  2010-08-12     Revised Date:  2011-09-06    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  433-42     Citation Subset:  IM    
Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
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MeSH Terms
Analysis of Variance
Case-Control Studies
Chi-Square Distribution
Heart Ventricles / physiopathology*,  ultrasonography
Image Interpretation, Computer-Assisted
Linear Models
Middle Aged
Myocardial Infarction / physiopathology*,  ultrasonography
ROC Curve
Sensitivity and Specificity
Torsion Abnormality / physiopathology*,  ultrasonography
Ventricular Remodeling / physiology*

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

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