Morphological and clinical aspects of acute postmyocardial remodeling in patients with pre-existing hypertrophy.

INTRODUCTION

Cardiac remodeling is a relevant and unfavorable evolution of myocardial infarction, which is associated with an increased risk of progression to overt heart failure (HF). It is currently acknowledged as a fundamental therapeutic objective that clinicians must address from the acute event to the comprehensive clinical follow-up.

AIM: The aim of the study was to assess the importance of left ventricular hypertrophy (LVH) in acute myocardial infarction (AMI) extension.

PATIENTS, MATERIALS AND

METHODS

Inclusion criteria: anterior V1-V4 ST-segment elevation myocardial infarction (STEMI) and left ventricular ejection fraction (LVEF) >50%.

EXCLUSION CRITERIA: other STEMI locations, heart disorders, systemic diseases. Patients underwent pharmacological or percutaneous revascularization. Echocardiography was performed until day 3 of AMI and after 14 days. To measure the length of the expansion segment (LES), an original mathematical formula was obtained using the parasternal short-axis view at the papillary muscle level, myocardial mass (MM), and interventricular septum thickness (IST). Statistical studies have used the Student's t-test, the linear regression equations and the Pearson's correlation coefficient.

RESULTS

172 AMI patients were analyzed and divided into two groups. Patients with LVH showed a strong reverse Pearson's correlation coefficient between LES and IST. For group II, a significant strongly reverse correlation for the LES and IST.

CONCLUSIONS

Pre-existing LVH in AMI is associated with the limitation of the expansion. In the group without LVH, a 1 cm increase in LES corresponds to a 0.0622 cm decrease in IST.