PMID- 30383552
OWN - NLM
STAT- MEDLINE
DCOM- 20191223
LR  - 20191223
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
VI  - 30
IP  - 1
DP  - 2019 Jan
TI  - Reverse, stationary and progressive left ventricular dilatation in dilated and 
      nondilated ventricles on admission following first anterior STEMI.
PG  - 11-19
LID - 10.1097/MCA.0000000000000665 [doi]
AB  - BACKGROUND: The relationship between admission left ventricular (LV) volumes, 
      regional contractility and persistent ST elevation in first anterior ST elevation 
      myocardial infarction (STEMI) with evolution of LV volumes at 12 months remains 
      inconclusive. Thus possible differences among patients with reverse dilatation 
      (RD), stationary dilatation (SD) or progressive dilatation (PD) at 12 months 
      based on left ventricle end-systolic volume (LVESV) index changes were 
      investigated. PATIENTS AND METHODS: ECG and echocardiographic features of 394 
      1-year survivors of anterior STEMI were analyzed at admission, 6 and 12 months in 
      those with RD (>/=15% reduction of LVESV index, at 12 months n=141), SD (<15% 
      reduction or increase, n=123) or PD (>/=15% increase, n=130). Long-term outcome was 
      also evaluated. RESULTS: Admission LVESV values in tertiles and incidence of 
      moderate-severe mitral regurgitation were similar in three groups. In patients 
      with RD, LVESV decreased at 6 months (P<0.001) and further at 12 months 
      (P=0.003), whereas in PD, it increased at 6 months (P<0.001) and further at 12 
      months (P=0.016). Contractility score in PD was higher on admission (P=0.050) 
      than in the other groups, but it involved the same segments. At 12 months, it 
      improved in each of the six most affected in RD (P<0.001) and SD (P=0.025-0.001) 
      but not in PD group (P=0.452-1.00). Persistent ST elevation at 24 h and peak 
      troponin I were the only independent predictors for RD (odds ratio: 0.900, 95% 
      confidence interval: 0.840-0.905, P=0.003; 0.996, 0.986-0.994, P<0.001) and PD 
      (1.143, 1.001-1.304, P=0.048; 1.004, 1.002-1.006, P<0.001), respectively. During 
      an 8-year follow-up, 77 (19.5%) patients died and although the total mortality 
      was comparable in the three groups, cardiac death or hospitalization for heart 
      failure was higher in the PD (16/130, 14%) than in the other two groups (14/250, 
      5.6%, P=0.014). CONCLUSION: Admission normal or enlarged LV volumes may evolve 
      towards RD, SD or PD at 12 months following first anterior STEMI mainly depending 
      in part on infarct size. Importantly, relevant changes occur at not only 6 months 
      but also between 6 and 12 months.
FAU - Figueras, Jaume
AU  - Figueras J
AD  - Coronary Care Unit, Cardiology Service, University Hospital Vall d'Hebron, 
      Barcelona, Spain.
FAU - Baneras, Jordi
AU  - Baneras J
FAU - Gruosso, Domenico
AU  - Gruosso D
FAU - Rodriguez Palomares, Jose
AU  - Rodriguez Palomares J
FAU - Barrabes, Jose A
AU  - Barrabes JA
FAU - Garcia-Dorado, David
AU  - Garcia-Dorado D
LA  - eng
PT  - Journal Article
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
SB  - IM
MH  - Anterior Wall Myocardial Infarction/*diagnosis/physiopathology
MH  - Cardiac Volume
MH  - Cardiomyopathy, Dilated/*diagnosis/etiology/physiopathology
MH  - Coronary Angiography
MH  - Disease Progression
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Ventricles/*diagnostic imaging/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Admission/*trends
MH  - Prognosis
MH  - Retrospective Studies
MH  - ST Elevation Myocardial Infarction/*diagnosis/physiopathology
MH  - Ventricular Function, Left/*physiology
MH  - *Ventricular Remodeling
EDAT- 2018/11/02 06:00
MHDA- 2019/12/24 06:00
CRDT- 2018/11/02 06:00
PHST- 2018/11/02 06:00 [pubmed]
PHST- 2019/12/24 06:00 [medline]
PHST- 2018/11/02 06:00 [entrez]
AID - 10.1097/MCA.0000000000000665 [doi]
PST - ppublish
SO  - Coron Artery Dis. 2019 Jan;30(1):11-19. doi: 10.1097/MCA.0000000000000665.