PMID- 9068904
OWN - NLM
STAT- MEDLINE
DCOM- 19970523
LR  - 20200225
IS  - 0160-9289 (Print)
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 20
IP  - 3
DP  - 1997 Mar
TI  - Changes of the left ventricle after myocardial infarction--estimation with cine 
      magnetic resonance imaging during the first six months.
PG  - 201-12
AB  - BACKGROUND: In recent years, the interest of cardiologists has focused 
      increasingly on the morphologic and functional changes of the left ventricle 
      after myocardial infarction (MI), due to their great prognostic significance for 
      the patient. HYPOTHESIS: The aim of this study was to evaluate changes in left 
      ventricular morphology and function during the first 6 months following MI. 
      METHODS: In all, 61 patients (17 women, 44 men, age 36-83 years) were examined 
      with cine magnetic resonance imaging (CMRI) 1, 4, and 26 weeks after myocardial 
      infarction. Thirty-two patients had anterior MI and 29 patients had posterior MI. 
      According to enzyme-derived infarct weight, 15 patients had small infarcts (< 20 
      g), 19 had intermediate-sized infarcts (20-40 g), and 27 patients had large 
      infarcts (> 40 g). CMRI was performed in the true short axis of the left 
      ventricle. In each examination, left ventricular end-diastolic and end-systolic 
      volume indices (LVEDVI, LVESVI), stroke volume index (LVSVI), ejection fraction 
      (LVEF), and regional thickness, mass, and motility of the myocardial 
      wall-diastolic thickness (IDdia), infarct mass (IM) and motility (IMOT) of the 
      infarct area and diastolic and systolic thickness (VDdia, VDsys), muscular mass 
      (VM), and motility (VMOT)-were determined. In addition, patients were divided 
      into subgroups according to New York Heart Association (NYHA) functional status 
      at baseline. RESULTS: In the total group, LVEDVI increased from 73.9 +/- 23.5 
      ml/m2 to 85.4 +/- 28.1 ml/m2 (p < 0.001) and LVESVI from 40.5 +/- 19.4 ml/m2 to 
      51.2 +/- 29.0 ml/m2 (p < 0.001). In the subgroups the development depended on 
      infarct size and location. LVSVI and LVEF remained more or less constant except 
      for large anterior infarctions. All changes of the myocardial wall depended on 
      infarct size and location: In all patients IDdia decreased from 10.4 +/- 1.6 mm 
      to 8.9 +/- 1.7 mm (p < 0.001), IMOT from 2.0 +/- 1.6 mm to 0.5 +/- 2.9 mm (p < 
      0.001). IM increased from 41 +/- 21 g to 45 +/- 25 g (p < 0.001). In the total 
      group, VDdia increased from 11.9 +/- 1.6 mm to 12.4 +/- 1.8 mm (p < 0.05), VDsys 
      from 16.6 +/- 2.5 mm to 17.2 +/- 3.1 mm (p < 0.05). In the subgroups changes 
      varied: VDdia and VDsys decreased markedly in large anterior wall infarctions. VM 
      increased in the total cohort from a mean of 246 +/- 66 g to 276 +/- 80 g (p < 
      0.001). VMOT decreased from 7.1 +/- 2.4 mm to 6.3 +/- 2.7 mm (p < 0.05). Loss of 
      motility was most pronounced in anterior infarctions. The volume-mass ratio, a 
      measure of the success of compensation of volume increase by myocardial 
      hypertrophy, decreased in small infarcts, remained unchanged in intermediate 
      infarcts, and increased in large infarcts. There was a trend toward improvement 
      of the NYHA functional status during the observation period. CONCLUSIONS: Changes 
      of the left ventricular chamber during the first 6 months following MI are 
      dependent on its size and location, with large anterior infarctions having the 
      worst course. Myocardial wall remodeling is also dependent on infarct size and 
      location, and the volume-mass ratio increases in the presence of large areas of 
      necrosis, indicating the non-compensatory effect of myocardial hypertrophy. 
      However, these changes have no clinical effect during the first half year after 
      MI.
FAU - Konermann, M
AU  - Konermann M
AD  - Department of Internal Medicine, University of Bochum, Marienhospital, Herne, 
      Germany.
FAU - Sanner, B M
AU  - Sanner BM
FAU - Horstmann, E
AU  - Horstmann E
FAU - Grotz, J
AU  - Grotz J
FAU - Laschewski, F
AU  - Laschewski F
FAU - Josephs, W
AU  - Josephs W
FAU - Odenthal, H J
AU  - Odenthal HJ
FAU - Sturm, A
AU  - Sturm A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Myocardial Infarction/diagnosis/*physiopathology
MH  - Stroke Volume
MH  - Time Factors
MH  - *Ventricular Function, Left
PMC - PMC6655284
EDAT- 1997/03/01 00:00
MHDA- 1997/03/01 00:01
PMCR- 2009/02/03
CRDT- 1997/03/01 00:00
PHST- 1997/03/01 00:00 [pubmed]
PHST- 1997/03/01 00:01 [medline]
PHST- 1997/03/01 00:00 [entrez]
PHST- 2009/02/03 00:00 [pmc-release]
AID - CLC4960200305 [pii]
AID - 10.1002/clc.4960200305 [doi]
PST - ppublish
SO  - Clin Cardiol. 1997 Mar;20(3):201-12. doi: 10.1002/clc.4960200305.