Cardiac dyssynchrony correlates with left ventricular remodeling after myocardial infarction
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Date
2009
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SOC MEDICA SANTIAGO
Abstract
Background: Cardiac dyssynchrony is common in advanced heart failure (HF), but the changes in cardiac synchrony after myocardial infarction (MI) have not been adequately described. Aim: To study the relationship between cardiac synchrony and left ventricular remodeling after acute myocardial infarction. Material and methods: Forty nine patients aged 59+/-10 years (77% men) with a first episode of a ST segment elevation MI were studied. Scintigraphic left ventricular function and synchrony analyses were performed at baseline and after a six months follow-up. Determinations were compared with 33 healthy subjects. Results: At baseline, patients with MI had a decreased left ventricular ejection fraction (LVEF) and significant dyssynchrony, when compared with controls. LVEF was 36.4%+/-10%, left ventricular end-diastolic volume (LVEDV) 127+/-38 mL, interventricular delay (IEV) 29+/-35 milliseconds (ms), and intraventricular delay (IAV), 234+/-89 ms. After 6 months, LVEF significantly improved (38%+/-10%, p = 0.042) without significant changes in LVEDV (129+/-32 mL, p = 0.97), IEV (24+/-17, p = 0.96) or IAV (231 +/- 97, p = 0.34). At baseline there were significant correlations between IAV and LVEF, and between IAV and LVEDV (r = -0.48, p = 0.001 and r = -0.41, p = 0.004, respectively). These correlations remained significant after 6 months. There was a positive correlation between IAV and LVEDV changes at six months (r = 0.403, p = 0.04). Conclusions: The development of cardiac dyssynchrony correlates with adverse left ventricular remodeling after MI (Rev Med Chile 2009; 137: 1457-62).
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Keywords
Cardiac dyssynchrony, Myocardial infarction, Ventricular remodeling, HEART-FAILURE PATIENTS, INTRAVENTRICULAR DYSSYNCHRONY, RESYNCHRONIZATION THERAPY, DILATED CARDIOMYOPATHY, CONTRACTION, MORTALITY