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Link between Left Cavity Remodeling and Acute Alteration of Regional Contractility after Re-Vascularized Critical Myocardial Infarction
Research Article
Tshetiz Dahal, Ashish Chaurel and Anil Tamang
3D echocardiography
Acute myocardial infarction
Ventricular dysfunction.
Aim: The purpose of the current study is to show how acute regional contractility impairment, as determined by 3D echocardiography, can be used to predict LV remodelling in individuals who have experienced an acute myocardial infarction (AMI). Methods: We enrolled 48 AMI patients in the trial who underwent primary PCI and afterwards received the best available medical care. Regional contractility in the immediate post-infarction period, as measured by 3D echo parameters at baseline: regional index of contraction amplitude (RICA) and the index of contraction amplitude, were correlated with the amplitude of ventricular remodelling at 6 months post-infarction in all of these cases (ICA). A rise in LV end-diastolic global volume of more than >15% from baseline was considered positive remodelling (PR). Results: Patients with positive remodeling (PR) presented at baseline a significantly lower ejection fraction (44.75% versus 49.95%, p = 0.009), associated with a higher end-systolic volume (80.34 ml vs. 70.63 ml, p = 0.02) and lower values for index of contraction amplitude — ICA (3.05 vs. 3.53, p = 0.01) and for regional index of contraction amplitude — RICA (1.38 vs. 2.78, p <0.0001), in comparison with the patients who did not experience ventricular re-modeling. RICA achieved the best statistical significance for predicting the development of LV remodeling during the evolution of the disease. For RICA, the ROC curve using logistic analysis showed an area under the curve (AUC) of 0.88, highly significant (p = 0.0001).Conclusions: Impairment of regional contractility is associated with development of LV re-modeling to a more significant extent than the global impairment of ventricular contractility.
Nov. 10, 2022
Volume:3 | Issue:6 (2022)
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