High-risk patients with mild-moderate left ventricular dysfunction after a previous myocardial infarction. A long-term prognostic data by cardiac magnetic resonance

In patients with ST-segment elevation myocardial infarction (STEMI), it is unclear if combined assessment of left ventricular end-diastolic pressure (LVEDP) and left ventricular ejection fraction (LVEF) improves prediction of major adverse cardiac events (MACE). We analyzed data from 266 STEMI patients who underwent successful percutaneous coronary intervention and subsequent left ventriculography (LVG). Patients were divided into 4 groups, as follows: Group 1, LVEDP < 21 mmHg and LVEF ≥ 55%; Group 2, LVEDP < 21 mmHg and LVEF < 55%; Group 3, LVEDP ≥ 21 mmHg and LVEF ≥ 55%; and Group 4, LVEDP ≥ 21 mmHg and LVEF < 55%. Multivariate Cox proportional hazards analysis was used to determine if LVEDP and LVEF were associated with MACE (including cardiac death, non-fatal myocardial infarction, and heart failure requiring hospitalization). Change in LV parameters was assessed in the subset of 183 patients who underwent serial LVG (mean interval 6.3 ± 1.6 months). During a mean follow-up of 43 ± 31 months, 29 patients (10.9%) had a MACE. As compared to Group 1, MACE risk was significantly higher in Group 3 [hazard ratio (HR) 3.26; 95% confidence interval (CI) 1.05-10.0] and Group 4 (HR 3.99; 95% CI 1.44-11.0), but not in Group 2 (HR 0.46, 95% CI 0.54-3.96). In sub-analyses, LV end-systolic volume index after PCI was significantly higher in Group 4 than in the other groups and remained higher during follow-up. Combined LVEDP/LVEF assessment was useful in predicting MACE after successful PCI for STEMI patients and could facilitate risk stratification, as it predicts LV remodeling.

show abstract

Combined assessment of left ventricular end-diastolic pressure and ejection fraction by left ventriculography predicts long-term outcomes of patients with ST-segment elevation myocardial infarction

Saito

Nakanishi

Watanabe

et al. 2017

Heart Vessels

View full text Add to dashboard Cite

show abstract

Incremental value of high-risk CMR attributes to predict adverse remodeling after ST-segment elevation myocardial infarction across LVEF categories

Guo,

Wang,

Guo

et al. 2024

Hellenic Journal of Cardiology

View full text Add to dashboard Cite

Prognostic Significance of CMR Findings in Patients with Known Coronary Artery Disease – Experience from a South Asian Country

Ahmed

Sultan

Awan

et al. 2020

JCIS

View full text Add to dashboard Cite

Objectives: South Asians (SA) have a higher burden of coronary artery disease (CAD) and are known to have a worse prognosis compared to other ethnicities. Therefore, it is imperative to improve the risk stratification of SA patient with CAD and to seek out newer prognostic markers beyond the conventional echocardiography.The aim of this study was to investigate whether variables obtained by cardiac magnetic resonance (CMR) improve risk stratification of South Asian patients with known CAD. Material and Methods: We retrospectively analyzed 147 patients with evidence of CAD that had a CMR at our center between January 2011 and January 2019. LV volumes and regional wall motions were acquired by cine images, while infarct size (IS) was measured by late gadolinium enhancement. At a mean follow-up of 3.36 ± 2.22 years, cardiac events (non-fatal myocardial infarction, hospitalization due to heart failure, life-threatening arrhythmia, or cardiac death) occurred in 49 patients. An IS ≥35%, left ventricular ejection fraction (LVEF) ≤31%, and a wall motion score index (WMSI) ≥1.9 were strongly associated with follow-up cardiac events (P < 0.001). Patients that had none or less than 3 of these factors, showed a lower risk of cardiac events (HR 0.22 CI [0.11–0.44] P < 0.001 and HR 0.12 CI [0.04–0.32] P < 0.001, respectively) compared to those with all three factors. Conclusion: Integration of CMR derived factors such as IS and WMSI with LVEF can improve the prognostication of the SA population with CAD. Better risk stratification of patients can lead to improved and cost-effective therapeutic strategies to ameliorate the prognosis of these patients.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

High-risk patients with mild-moderate left ventricular dysfunction after a previous myocardial infarction. A long-term prognostic data by cardiac magnetic resonance

Cited by 3 publications

References 33 publications

Combined assessment of left ventricular end-diastolic pressure and ejection fraction by left ventriculography predicts long-term outcomes of patients with ST-segment elevation myocardial infarction

Combined assessment of left ventricular end-diastolic pressure and ejection fraction by left ventriculography predicts long-term outcomes of patients with ST-segment elevation myocardial infarction

Incremental value of high-risk CMR attributes to predict adverse remodeling after ST-segment elevation myocardial infarction across LVEF categories

Prognostic Significance of CMR Findings in Patients with Known Coronary Artery Disease – Experience from a South Asian Country

Contact Info

Product

Resources

About