3D Echo Pilot Study of Geometric Left Ventricular Changes after Acute Myocardial Infarction

Abstract

BackgroundLeft ventricular remodeling (LVR) after AMI characterizes a factor of poor prognosis. There is little information in the literature on the LVR analyzed with three-dimensional echocardiography (3D ECHO). ObjectiveTo analyze, with 3D ECHO, the geometric and volumetric modifications of the left ventricle (VE) six months after AMI in patients subjected to percutaneous primary treatment. MethodsProspective study with 3D ECHO of 21 subjects (16 men, 56 ± 12 years-old), affected by AMI with ST segment elevation. The morphological and functional analysis (LV) with 3D ECHO (volumes, LVEF, 3D sphericity index) was carried out up to seven days and six months after the AMI. The LVR was considered for increase > 15% of the end diastolic volume of the LV (LVEDV) six months after the AMI, compared to the LVEDV up to seven days from the event. ResultsEight (38%) patients have presented LVR. Echocardiographic measurements (n = 21 patients): I- up to seven days after the AMI: 1- LVEDV: 92.3 ± 22.3 mL; 2- LVEF: 0.51 ± 0.01; 3- sphericity index: 0.38 ± 0.05; II- after six months: 1- LVEDV: 107.3 ± 26.8 mL; 2- LVEF: 0.59 ± 0.01; 3- sphericity index: 0.31 ± 0.05. Correlation coefficient (r) between the sphericity index up to seven days after the AMI and the LVEDV at six months (n = 8) after the AMI: r: 0.74, p = 0.0007; (r) between the sphericity index six months after the AMI and the LVEDV at six months after the AMI: r: 0.85, p < 0.0001. ConclusionIn this series, LVR has been observed in 38% of the patients six months after the AMI. The three-dimensional sphericity index has been associated to the occurrence of LVR.

Effectiveness of bone marrow mononuclear cells delivered through a graft vessel for patients with previous myocardial infarction and chronic heart failure: an echocardiographic study of left ventricular remodeling.

“…The prognosis of the patients bearing myocardial infarction is related to the cardiac mechanics and to the geometry of the left ventricle as well [19] and limiting the ventricular remodeling is one of the objectives for improving ventricular function and clinical outcome [14]. The LV function is an important part of the whole heart function.…”

Intermediate Monocytes Lead to Enhanced Myocardial Remodelling in STEMI Patients With Diabetes

“…13,14) We did not observe significant differences regarding LVEF or infarction size (%) between the groups at these two time points, although a slight difference in infarction size was observed in STEMI patients with diabetes compared to the control at 3 days (0.50 ± 0.15 versus 0.52 ± 0.22, P = 0.59) and at 6 months (0.36 ± 0.11 versus 0.34 ± 0.15, P = 0.42) (Supplemental Figure 1). However, there was a significant difference in the reduction of the infarction size between STEMI patients with diabetes and the control group at 6 months (0.14 ± 0.06 versus 0.18 ± 0.09, P < 0.001).…”

Three‐dimensional echocardiographic comparison of left ventricular geometry and systolic function between dilated cardiomyopathy and mitral regurgitation with similar left ventricular dilation

“…Depth and scan width were optimized to reach a frame rate > 20/s. The LV overall shape was evaluated using three‐dimensional sphericity index (3D‐SI) which was calculated by dividing three‐dimensional LVEDV by the volume of a sphere whose diameter was the LV end‐diastolic long axis in the apical four‐chamber 3D image . Measurements of 3D volumes and 3D‐EF were performed off‐line using QLAB software.…”