Background Left ventricular(LV) remodeling after acute myocardial infarction(AMI) is a serious medical sequale. LV dyssynchrony was suggested as a predictor of LV remodeling. We investigated the relations of dyssynchrony immediately after AMI and LV remodeling, using tagging magnetic resonance imaging(MRI) MRI derived matric.
Method Total 42 patients diagnosed with ST elevation MI were enrolled. After treatment with primary intervention, cardiac MRI study was performed including cine, delayed enhancement, and tagged MRI protocol and LV volume, ejection fraction, and infarct size were measured. Circumferential uniformity ratio estimated (CURE) was calculated as a dyssynchrony index from tagged MRI using HARP software (CURE 0→1: dyssynchrony→synchrony). After 6month, follow-up MRI was performed to assess the degree of LV remodeling.
Results Six months after AMI, 13 patients(30%) showed increased LV end systolic volume(ESV) more than 20% than baseline. Baseline LV dyssynchrony index(CURE) was not correlated with infarct size or LV ESV immediately after AMI, but significantly related with ESV at 6 month (r=-0.5, p=0.001, Figure). In multivariate analysis, baseline ESV (p<0.001) and CURE (p=0.001) were associated with change of LV ESV,(R2=0.644) suggesting as strong determinants of LV remodeling.
Conclusion LV dyssynchrony, immediately after AMI is important determinant of LV remodeling and tagging MRI derived matric of dyssynchorny, CURE, is possibly useful to predict the LV remodeling in AMI patients.
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