Computational investigation of the effect of pre-existing silent myocardial infarction on acute myocardial infarction.

Recent clinical studies have reported that the pre-existence of unnoticed silent myocardial infarction (SMI) in patients hospitalized with acute myocardial infarction (AMI) significantly worsens morbidity and increases mortality. SMI patients exhibit infarcts of different sizes and locations. This condition occurs in conjunction with left ventricular (LV) hypertrophy. The distinct roles of these abnormalities on LV functions and their contribution to AMI prognosis are poorly understood. To address these gaps, this study utilizes a coupled finite element (FE) framework to investigate the effect of the size and location of isolated SMI and AMI on LV performance. Furthermore, the influence of the simultaneous occurrence of SMI and hypertrophy alongside AMI is evaluated. The results show that under the simulation conditions, the peak global longitudinal strain is influenced by the variation in the location and size of the SMI and AMI. However, ejection fraction (EF), end-diastolic pressure (EDP), and peak global circumferential strain are influenced by the size of the SMI. The findings indicate that the presence of pre-existing SMI and hypertrophy will notably impair the EF and global circumferential strain, resulting in worse morbidity in an AMI patient.