Prognosis-based definition of left ventricular remodeling after ST-elevation myocardial infarction

• DOI: 10.1007/s00330-018-5875-3
• Publication Date: 2018-12-13T04:36:41Z
• Authors: Martin Reindl; Sebastian Johanne...; Christina Tiller; Hans-Josef Feistr...; Markus Kofler; Alexandra Brix; Agnes Mayr; Gert Klug; Bernhard Metzler
• Keywords: Mace; Clinical endpoint; Ventricular remodeling

Cardiac magnetic resonance (CMR) is the gold-standard modality for assessment of left ventricular (LV) remodeling in ST-elevation myocardial infarction (STEMI) patients. However, commonly used criteria have never been validated hard clinical events. We therefore aimed to define clear CMR LV following STEMI with proven prognostic impact. This observational study included 224 patients suffering from acute STEMI. was performed within 1 week and 4 months after evaluate different including relative changes end-diastolic volume (%∆LVEDV), end-systolic (%∆LVESV), ejection fraction (%∆LVEF), mass (%∆LVMM). Primary endpoint occurrence major adverse cardiovascular events (MACE) all-cause death, re-infarction, stroke, new congestive heart failure 24 Secondary defined as composite primary hospitalization. The Mann–Whitney U test applied assess differences measures between without MACE. Values prediction secondary endpoints were assessed by c-statistics Cox regression analysis. incidence MACE (n = 13, 6%) associated higher %∆LVEDV (p 0.002) %∆LVMM 0.02), whereas %∆LVESV %∆LVEF not significantly related > 0.05). area under curve (AUC) 0.76 (95% confidence interval [CI], 0.65–0.87) (optimal cut-off 10%) 0.69 (95%CI, 0.52–0.85) 5%). From all criteria, ≥ 10% showed highest hazard ratio (8.68 [95%CI, 2.39–31.56]; p 0.001) Regarding 35, 16%), also an optimal threshold emerged strongest prognosticator (AUC 0.66; 95%CI, 0.56–0.75; 0.004). Following revascularized STEMI, association outcome, suggesting this criterion preferred CMR-based definition post-STEMI remodeling. • CMR-determined Neither nor a significant relation 10 revealed validity.