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Predictors of left ventricular remodeling after ST-elevation myocardial infarction
Adverse left ventricular (LV) remodeling after acute ST-elevation myocardial infarction (STEMI) is associated with morbidity and mortality. We studied clinical, biochemical and angiographic determinants of LV end diastolic volume index (LVEDVi), end systolic volume index (LVESVi) and mass index (LVM...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539273/ https://www.ncbi.nlm.nih.gov/pubmed/28389968 http://dx.doi.org/10.1007/s10554-017-1131-1 |
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author | Hendriks, Tom Hartman, Minke H. T. Vlaar, Pieter J. J. Prakken, Niek H. J. van der Ende, Yldau M. Y. Lexis, Chris P. H. van Veldhuisen, Dirk J. van der Horst, Iwan C. C. Lipsic, Erik Nijveldt, Robin van der Harst, Pim |
author_facet | Hendriks, Tom Hartman, Minke H. T. Vlaar, Pieter J. J. Prakken, Niek H. J. van der Ende, Yldau M. Y. Lexis, Chris P. H. van Veldhuisen, Dirk J. van der Horst, Iwan C. C. Lipsic, Erik Nijveldt, Robin van der Harst, Pim |
author_sort | Hendriks, Tom |
collection | PubMed |
description | Adverse left ventricular (LV) remodeling after acute ST-elevation myocardial infarction (STEMI) is associated with morbidity and mortality. We studied clinical, biochemical and angiographic determinants of LV end diastolic volume index (LVEDVi), end systolic volume index (LVESVi) and mass index (LVMi) as global LV remodeling parameters 4 months after STEMI, as well as end diastolic wall thickness (EDWT) and end systolic wall thickness (ESWT) of the non-infarcted myocardium, as compensatory remote LV remodeling parameters. Data was collected in 271 patients participating in the GIPS-III trial, presenting with a first STEMI. Laboratory measures were collected at baseline, 2 weeks, and 6–8 weeks. Cardiovascular magnetic resonance imaging (CMR) was performed 4 months after STEMI. Linear regression analyses were performed to determine predictors. At baseline, patients were 21% female, median age was 58 years. At 4 months, mean LV ejection fraction (LVEF) was 54 ± 9%, mean infarct size was 9.0 ± 7.9% of LVM. Strongest univariate predictors (all p < 0.001) were peak Troponin T for LVEDVi (R(2) = 0.26), peak CK-MB for LVESVi (R(2) = 0.41), NT-proBNP at 2 weeks for LVMi (R(2) = 0.24), body surface area for EDWT (R(2) = 0.32), and weight for ESWT (R(2) = 0.29). After multivariable analysis, cardiac biomarkers remained the strongest predictors of LVMi, LVEDVi and LVESVi. NT-proBNP but none of the acute cardiac injury biomarkers were associated with remote LV wall thickness. Our analyses illustrate the value of cardiac specific biochemical biomarkers in predicting global LV remodeling after STEMI. We found no evidence for a hypertrophic response of the non-infarcted myocardium. |
format | Online Article Text |
id | pubmed-5539273 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-55392732017-08-17 Predictors of left ventricular remodeling after ST-elevation myocardial infarction Hendriks, Tom Hartman, Minke H. T. Vlaar, Pieter J. J. Prakken, Niek H. J. van der Ende, Yldau M. Y. Lexis, Chris P. H. van Veldhuisen, Dirk J. van der Horst, Iwan C. C. Lipsic, Erik Nijveldt, Robin van der Harst, Pim Int J Cardiovasc Imaging Original Paper Adverse left ventricular (LV) remodeling after acute ST-elevation myocardial infarction (STEMI) is associated with morbidity and mortality. We studied clinical, biochemical and angiographic determinants of LV end diastolic volume index (LVEDVi), end systolic volume index (LVESVi) and mass index (LVMi) as global LV remodeling parameters 4 months after STEMI, as well as end diastolic wall thickness (EDWT) and end systolic wall thickness (ESWT) of the non-infarcted myocardium, as compensatory remote LV remodeling parameters. Data was collected in 271 patients participating in the GIPS-III trial, presenting with a first STEMI. Laboratory measures were collected at baseline, 2 weeks, and 6–8 weeks. Cardiovascular magnetic resonance imaging (CMR) was performed 4 months after STEMI. Linear regression analyses were performed to determine predictors. At baseline, patients were 21% female, median age was 58 years. At 4 months, mean LV ejection fraction (LVEF) was 54 ± 9%, mean infarct size was 9.0 ± 7.9% of LVM. Strongest univariate predictors (all p < 0.001) were peak Troponin T for LVEDVi (R(2) = 0.26), peak CK-MB for LVESVi (R(2) = 0.41), NT-proBNP at 2 weeks for LVMi (R(2) = 0.24), body surface area for EDWT (R(2) = 0.32), and weight for ESWT (R(2) = 0.29). After multivariable analysis, cardiac biomarkers remained the strongest predictors of LVMi, LVEDVi and LVESVi. NT-proBNP but none of the acute cardiac injury biomarkers were associated with remote LV wall thickness. Our analyses illustrate the value of cardiac specific biochemical biomarkers in predicting global LV remodeling after STEMI. We found no evidence for a hypertrophic response of the non-infarcted myocardium. Springer Netherlands 2017-04-07 2017 /pmc/articles/PMC5539273/ /pubmed/28389968 http://dx.doi.org/10.1007/s10554-017-1131-1 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Paper Hendriks, Tom Hartman, Minke H. T. Vlaar, Pieter J. J. Prakken, Niek H. J. van der Ende, Yldau M. Y. Lexis, Chris P. H. van Veldhuisen, Dirk J. van der Horst, Iwan C. C. Lipsic, Erik Nijveldt, Robin van der Harst, Pim Predictors of left ventricular remodeling after ST-elevation myocardial infarction |
title | Predictors of left ventricular remodeling after ST-elevation myocardial infarction |
title_full | Predictors of left ventricular remodeling after ST-elevation myocardial infarction |
title_fullStr | Predictors of left ventricular remodeling after ST-elevation myocardial infarction |
title_full_unstemmed | Predictors of left ventricular remodeling after ST-elevation myocardial infarction |
title_short | Predictors of left ventricular remodeling after ST-elevation myocardial infarction |
title_sort | predictors of left ventricular remodeling after st-elevation myocardial infarction |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539273/ https://www.ncbi.nlm.nih.gov/pubmed/28389968 http://dx.doi.org/10.1007/s10554-017-1131-1 |
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