Impact of Left Ventricular Dyssynchrony Early on Left Ventricular Function After First Acute Myocardial Infarction

Nucifora, Gaetano, Bertini, Matteo, Marsan, Nina Ajmone, Delgado, Victoria, Scholte, Arthur J., Ng, Arnold C. T., van Werkhoven, Jacob M., Siebelink, Hans-Marc J., Holman, Eduard R., Schalij, Martin J., van der Wall, Ernst E. and Bax, Jeroen J. (2010) Impact of Left Ventricular Dyssynchrony Early on Left Ventricular Function After First Acute Myocardial Infarction. American Journal of Cardiology, 105 3: 306-311. doi:10.1016/j.amjcard.2009.09.028

Author Nucifora, Gaetano
Bertini, Matteo
Marsan, Nina Ajmone
Delgado, Victoria
Scholte, Arthur J.
Ng, Arnold C. T.
van Werkhoven, Jacob M.
Siebelink, Hans-Marc J.
Holman, Eduard R.
Schalij, Martin J.
van der Wall, Ernst E.
Bax, Jeroen J.
Title Impact of Left Ventricular Dyssynchrony Early on Left Ventricular Function After First Acute Myocardial Infarction
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
Publication date 2010-02
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2009.09.028
Volume 105
Issue 3
Start page 306
End page 311
Total pages 6
Place of publication Bridgewater, NJ United States
Publisher Excerpta Medica
Collection year 2011
Language eng
Formatted abstract
The impact of left ventricular (LV) dyssynchrony after acute myocardial infarction (AMI) on LV ejection fraction (EF) is unknown. One hundred twenty-nine patients with a first ST-elevation AMI (58 ± 11 years, 78% men) and QRS duration <120 ms were included. All patients underwent primary percutaneous coronary intervention. Real-time 3-dimensional echocardiography and myocardial contrast echocardiography were performed to assess LV function, LV dyssynchrony, and infarct size. LV dyssynchrony was defined as the SD of the time to reach the minimum systolic volume for 16 LV segments, expressed in percent cardiac cycle (systolic dyssynchrony index [SDI]). Myocardial perfusion at myocardial contrast echocardiography was scored (1 = normal/homogenous; 2 = decreased/patchy; 3 = minimal/absent) using a 16-segment model; a myocardial perfusion index, expressing infarct size, was derived by summing segmental contrast scores and dividing by the number of segments. SDI in patients with AMI was 5.24 ± 2.23% compared to 2.02 ± 0.70% of controls (p <0.001). Patients with AMI and LVEF <45% had significantly higher SDI compared to patients with LVEF ≥45% (4.29 ± 1.44 vs 6.95 ± 2.40, p <0.001). At multivariate analysis, SDI was independently related to LVEF; in addition, the impact of SDI on LV systolic function was incremental to infarct size and anterior location of AMI (F change 16.9, p <0.001). In conclusion, LV synchronicity is significantly impaired soon after AMI. LV dyssynchrony is related to LVEF and has an additional detrimental effect on LV function, beyond infarct size and the anterior location of AMI.
Keyword Time 3 Dimensional Echocardiography
Cardiac Resynchronization Therapy
Congestive Heart Failure
Contrast Echocardiography
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: Mon, 15 Apr 2013, 00:06:17 EST by Dr Chin Tse Arnold Ng on behalf of School of Medicine