Nomogram Containing Simple Routine Clinical and Biochemical Parameters Can Predict Pathologic Ventricular Remodeling in STEMI Patients

Abstract

Heart failure is the leading cause of morbidity and mortality worldwide, with ischemic heart disease being one of the most important etiologic factors. Heart failure develops due to ventricular remodeling, which leads to increases in left ventricular end-systolic and end-diastolic volumes. In this prospective observational study, we included 101 patients with first episode of ST-segment elevation myocardial infarction in whom percutaneous coronary intervention was conducted within 12 h and Thrombolysis in Myocardial Infarction III flow was achieved. The aim was to determine which clinical and biochemical parameters can help predict pathologic ventricular remodeling 1 year after myocardial infarction. We created a nomogram based on routinely used blood tests and vital parameters which showed highest correlation with pathologic ventricular remodeling. The nomogram included NTproBNP value 12 h after reperfusion, aspartate transaminase value 12 h after reperfusion, systolic blood pressure value on admission, and culprit coronary artery. We performed ROC analysis which yielded great predictive value of the nomogram. The area under curve was 0.907 (95% CI 0.842-0.973). The nomogram value of -3.54 had 91.4% sensitivity and 74.0% specificity. We believe that this nomogram, once validated, could offer a widely available, low-cost option that would help identify patients at risk of developing pathologic left ventricular remodeling and achieve this at a very early stage of myocardial infarction (12 h after reperfusion has been achieved).

Continuous Cardiac Magnetic Resonance Imaging after Coronary Revascularization for Left Ventricular Dysfunction

“…The LVESVI of patients LVESVI increased accordingly. Vinter et al [29] stated that the detection of patients via cardiac MRI shows the great predictive value of LVESV for patient survival; in addition, the decrease in LVESV index leads to the increase in plasma B-type natriuretic peptide level in patients, which implies a serious ventricular systolic dysfunction (which is a high-risk factor related to clinically adverse outcomes). ( 4) CI is an evaluation index for the cardiac function of patients, and it represents the ability of the heart to function.…”