3D Echo pilot study of geometric left ventricular changes after acute myocardial infarction.

Autor: Vieira ML; Hospital Israelita Albert Einstein, São Paulo, SP - Brazil. mlvieira@cardiol.br, Oliveira WA, Cordovil A, Rodrigues AC, Mônaco CG, Afonso T, Lira Filho EB, Perin M, Fischer CH, Morhy SS
Jazyk: English; Portuguese
Zdroj: Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2013 Jul; Vol. 101 (1), pp. 43-51. Date of Electronic Publication: 2013 May 31.
DOI: 10.5935/abc.20130112
Abstrakt: Background: Left ventricular remodeling (LVR) after AMI characterizes a factor of poor prognosis. There is little information in the literature on the LVR analyzed with three-dimensional echocardiography (3D ECHO).
Objective: To analyze, with 3D ECHO, the geometric and volumetric modifications of the left ventricle (VE) six months after AMI in patients subjected to percutaneous primary treatment.
Methods: Prospective study with 3D ECHO of 21 subjects (16 men, 56 ± 12 years-old), affected by AMI with ST segment elevation. The morphological and functional analysis (LV) with 3D ECHO (volumes, LVEF, 3D sphericity index) was carried out up to seven days and six months after the AMI. The LVR was considered for increase > 15% of the end diastolic volume of the LV (LVEDV) six months after the AMI, compared to the LVEDV up to seven days from the event.
Results: Eight (38%) patients have presented LVR. Echocardiographic measurements (n = 21 patients): I- up to seven days after the AMI: 1- LVEDV: 92.3 ± 22.3 mL; 2- LVEF: 0.51 ± 0.01; 3- sphericity index: 0.38 ± 0.05; II- after six months: 1- LVEDV: 107.3 ± 26.8 mL; 2- LVEF: 0.59 ± 0.01; 3- sphericity index: 0.31 ± 0.05. Correlation coefficient (r) between the sphericity index up to seven days after the AMI and the LVEDV at six months (n = 8) after the AMI: r: 0.74, p = 0.0007; (r) between the sphericity index six months after the AMI and the LVEDV at six months after the AMI: r: 0.85, p < 0.0001.
Conclusion: In this series, LVR has been observed in 38% of the patients six months after the AMI. The three-dimensional sphericity index has been associated to the occurrence of LVR.
Databáze: MEDLINE