Document Detail


Usefulness of left ventricular dyssynchrony after acute myocardial infarction, assessed by a tagging magnetic resonance image derived metric, as a determinant of ventricular remodeling.
MedLine Citation:
PMID:  19576315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Development of left ventricular (LV) remodeling after acute myocardial infarction (AMI) is a serious medical complication. We investigated the correlation of LV dyssynchrony after AMI with LV remodeling using magnetic resonance-myocardial tagging (MR-MT) derived dyssynchrony index (circumferential uniformity ratio estimate [CURE]). Forty-three patients diagnosed with ST-elevation AMI were analyzed. After treatment with primary percutaneous intervention, cardiac magnetic resonance imaging was performed to obtain a cine image, a delayed enhancement image, and an MR-MT image. CURE as a dyssynchrony index was calculated from the MR-MT image using HARP software (CURE 0 to 1 = dyssynchrony to synchrony). After 6 months, follow-up cardiac magnetic resonance imaging was performed to assess degree of LV remodeling. Sixteen patients (37%) had an increased LV end-systolic volume (ESV) >15% compared with baseline. The baseline LV dyssynchrony index, CURE, was significantly associated with ESV at 6 months (r = -0.49, p <0.001) and weakly correlated with change in ESV (percentage) compared with baseline values (r = -0.26, p = 0.08). Multivariate analysis showed that CURE was associated only with change in ESV (beta -0.39, p = 0.03). Subgroup analysis for patients with nonviable myocardium (infarct thickness >75%, n = 31) showed that this correlation was stronger (beta -0.52, p = 0.006), suggesting that CURE could predict progression of LV remodeling in patients with AMI and nonviable myocardium. LV dyssynchrony immediately after AMI is an important determinant of LV remodeling. In conclusion, the MR-MT dyssynchrony index, CURE, might be useful for prediction of LV remodeling in patients with AMI.
Authors:
Sung-A Chang; Hyuk-Jae Chang; Sang Il Choi; Eun Ju Chun; Yeonyee E Yoon; Hyung-Kwan Kim; Yong-Jin Kim; Dong-Ju Choi; Dae-Won Sohn; Robert H Helm; Albert C Lardo
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Publication Detail:
Type:  Journal Article     Date:  2009-05-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  19-23     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Cardiovascular Center, Seoul National University, Bundang Hospital, Gyeonggi-Do, Korea.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Angioplasty, Transluminal, Percutaneous Coronary
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Arrhythmias, Cardiac / diagnosis,  etiology,  physiopathology
Female
Humans
Hypertrophy, Left Ventricular / diagnosis*,  etiology,  physiopathology
Magnetic Resonance Imaging*
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / pathology,  physiopathology,  therapy*
Prospective Studies
Statistics as Topic
Ventricular Dysfunction, Left / diagnosis*,  etiology,  physiopathology
Ventricular Remodeling*
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors

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