Left ventricular muscle and fluid mechanics in acute myocardial infarction

Nucifora, Gaetano, Delgado, Victoria, Bertini, Matteo, Marsan, Nina Ajmone, Van de Veire, Nico R., Ng, Arnold C. T., Siebelink, Hans-Marc J., Schalij, Martin J., Holman, Eduard R., Sengupta, Partho P. and Bax, Jeroen J. (2010) Left ventricular muscle and fluid mechanics in acute myocardial infarction. American Journal of Cardiology, 106 10: 1404-1409. doi:10.1016/j.amjcard.2010.06.072

Author Nucifora, Gaetano
Delgado, Victoria
Bertini, Matteo
Marsan, Nina Ajmone
Van de Veire, Nico R.
Ng, Arnold C. T.
Siebelink, Hans-Marc J.
Schalij, Martin J.
Holman, Eduard R.
Sengupta, Partho P.
Bax, Jeroen J.
Title Left ventricular muscle and fluid mechanics in acute myocardial infarction
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
Publication date 2010-11
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2010.06.072
Volume 106
Issue 10
Start page 1404
End page 1409
Total pages 6
Place of publication Bridgewater, NJ United States
Publisher Excerpta Medica
Collection year 2011
Language eng
Formatted abstract
Left ventricular (LV) diastolic filling is characterized by the formation of intraventricular rotational bodies of fluid (termed "vortex rings") that optimize the efficiency of LV ejection. The aim of the present study was to evaluate the morphology and dynamics of LV diastolic vortex ring formation early after acute myocardial infarction (AMI), in relation to LV diastolic function and infarct size. A total of 94 patients with a first ST-segment elevation AMI (59 ± 11 years; 78% men) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, the following examinations were performed: 2-dimensional echocardiography with speckle-tracking analysis to assess the LV systolic and diastolic function, the vortex formation time (VFT, a dimensionless index for characterizing vortex formation), and the LV untwisting rate; contrast echocardiography to assess LV vortex morphology; and myocardial contrast echocardiography to identify the infarct size. Patients with a large infarct size (<3 LV segments) had a significantly lower VFT (p <0.001) and vortex sphericity index (p <0.001). On univariate analysis, several variables were significantly related to the VFT, including anterior AMI, LV end-systolic volume, LV ejection fraction, grade of diastolic dysfunction, LV untwisting rate, and infarct size. On multivariate analysis, the LV untwisting rate (β = -0.43, p <0.001) and infarct size (β = -0.33, p = 0.005) were independently associated with VFT. In conclusion, early in AMI, both the LV infarct size and the mechanical sequence of diastolic restoration play key roles in modulating the morphology and dynamics of early diastolic vortex ring formation.
Keyword Model Left Ventricle
Contrast Echocardiography
Vortex Formation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Sun, 14 Apr 2013, 23:58:18 EST by Dr Chin Tse Arnold Ng on behalf of School of Medicine