Predictive value of early cardiac magnetic resonance imaging functional and geometric indexes for adverse left ventricular remodelling in patients with anterior ST-segment elevation myocardial infarction: A report from the CIRCUS study.
Aged
Anterior Wall Myocardial Infarction
/ diagnostic imaging
Cyclosporine
/ administration & dosage
Double-Blind Method
Early Diagnosis
Female
France
Heart Disease Risk Factors
Humans
Injections, Intravenous
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Percutaneous Coronary Intervention
Predictive Value of Tests
Risk Assessment
ST Elevation Myocardial Infarction
/ diagnostic imaging
Time Factors
Treatment Outcome
Ventricular Function, Left
Ventricular Remodeling
Cardiac magnetic resonance
Conicity index
Indice de conicité
Indice de sphéricité
Indice fonctionnel global ventriculaire gauche
Infarctus du myocarde
Myocardial infarction
Remodelage ventriculaire
Résonance magnétique cardiaque
Sphericity index
Ventricular remodelling
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
25
02
2020
revised:
17
04
2020
accepted:
13
05
2020
pubmed:
9
11
2020
medline:
16
12
2020
entrez:
8
11
2020
Statut:
ppublish
Résumé
Postinfarction adverse left ventricular (LV) remodelling is strongly associated with heart failure events. Conicity index, sphericity index and LV global functional index (LVGFI) are new LV remodelling indexes assessed by cardiac magnetic resonance (CMR). To assess the predictive value of the new indexes for 1-year adverse LV remodelling in patients with anterior ST-segment elevated myocardial infarction (STEMI). CMR studies were performed in 129 patients with anterior STEMI (58±12 years; 78% men) from the randomized CIRCUS trial (CMR substudy) treated with primary percutaneous coronary intervention and followed for the occurrence of major adverse cardiovascular events (MACE) (death or hospitalization for heart failure). Conicity index, sphericity index, LVGFI, infarct size and microvascular obstruction (MVO) were assessed by CMR performed 5±4 days after coronary reperfusion. Adverse LV remodelling was defined as an increase in LV end-diastolic volume of ≥15% by transthoracic echocardiography at 1 year. Adverse LV remodelling occurred in 27% of patients at 1 year. Infarct size and MVO were significantly predictive of adverse LV remodelling: odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.05 (P<0.001) and OR 1.12, 95% CI 1.05-1.22 (P<0.001), respectively. Among the newly tested indexes, only LVGFI was significantly predictive of adverse LV remodelling (OR 1.10, 95% CI 1.03-1.16; P=0.001). In multivariable analysis, infarct size remained an independent predictor of adverse LV remodelling at 1 year (OR 1.05, 95% CI 1.02-1.08; P<0.001). LVGFI and infarct size were associated with occurrence of MACE: OR 1.21, 95% CI 1.08-1.37 (P<0.001) and OR 1.02, 95% CI 1.00-1.04 (P=0.018), respectively. Conicity and sphericity indexes were not associated with MACE. LVGFI was associated with adverse LV remodelling and MACE 1 year after anterior STEMI.
Sections du résumé
BACKGROUND
BACKGROUND
Postinfarction adverse left ventricular (LV) remodelling is strongly associated with heart failure events. Conicity index, sphericity index and LV global functional index (LVGFI) are new LV remodelling indexes assessed by cardiac magnetic resonance (CMR).
AIM
OBJECTIVE
To assess the predictive value of the new indexes for 1-year adverse LV remodelling in patients with anterior ST-segment elevated myocardial infarction (STEMI).
METHODS
METHODS
CMR studies were performed in 129 patients with anterior STEMI (58±12 years; 78% men) from the randomized CIRCUS trial (CMR substudy) treated with primary percutaneous coronary intervention and followed for the occurrence of major adverse cardiovascular events (MACE) (death or hospitalization for heart failure). Conicity index, sphericity index, LVGFI, infarct size and microvascular obstruction (MVO) were assessed by CMR performed 5±4 days after coronary reperfusion. Adverse LV remodelling was defined as an increase in LV end-diastolic volume of ≥15% by transthoracic echocardiography at 1 year.
RESULTS
RESULTS
Adverse LV remodelling occurred in 27% of patients at 1 year. Infarct size and MVO were significantly predictive of adverse LV remodelling: odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.05 (P<0.001) and OR 1.12, 95% CI 1.05-1.22 (P<0.001), respectively. Among the newly tested indexes, only LVGFI was significantly predictive of adverse LV remodelling (OR 1.10, 95% CI 1.03-1.16; P=0.001). In multivariable analysis, infarct size remained an independent predictor of adverse LV remodelling at 1 year (OR 1.05, 95% CI 1.02-1.08; P<0.001). LVGFI and infarct size were associated with occurrence of MACE: OR 1.21, 95% CI 1.08-1.37 (P<0.001) and OR 1.02, 95% CI 1.00-1.04 (P=0.018), respectively. Conicity and sphericity indexes were not associated with MACE.
CONCLUSIONS
CONCLUSIONS
LVGFI was associated with adverse LV remodelling and MACE 1 year after anterior STEMI.
Identifiants
pubmed: 33160891
pii: S1875-2136(20)30221-7
doi: 10.1016/j.acvd.2020.05.024
pii:
doi:
Substances chimiques
Cyclosporine
83HN0GTJ6D
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
710-720Informations de copyright
Copyright © 2020. Published by Elsevier Masson SAS.