This article is more than 5 years old. Information may no longer be current.
LV dyssynchrony after MI was predictive of death, HF
Click Here to Manage Email Alerts
Echocardiography-assessed left ventricular dyssynchrony following MI was independently associated with an elevated risk for death or HF, and the contractile pattern may help with post-MI prognosis.
Researchers from the United States and Denmark examined a sample of 610 patients with LV dysfunction from the main VALIANT study population who were enrolled in the VALIANT echocardiography study between 12 hours and 10 days after acute MI onset. Among these patients, 381 had image quality sufficient for dyssynchrony analysis using B-mode speckle tracking with velocity vector imaging.
The researchers measured time to regional peak velocity and time to strain rate among 12 LV segments. The standard deviations among all 12 segments were used as a measure of dyssynchrony, and the relationship between dyssynchrony and the clinical outcomes of death or HF was assessed. Patients were followed up six times during the first year and every four months afterward.
A multivariate Cox model adjusted for clinical and echocardiographic variables suggested that the SD of time to peak velocity (HR per 10 milliseconds, 1.10; 95% CI, 1.02-1.18) and the SD of time to strain rate (HR per 10 milliseconds, 1.16; 95% CI, 1.06-1.27) were independent predictors of HF or death. Among the patients, 67 died during the median follow-up of 611 days (17.5%), with 61 as a result of a CV cause (15.9%). Also, 105 patients were either hospitalized or died from HF (27.4%).
“In patients with LV dysfunction, HF or both, mechanical dyssynchrony was an independent predictor of outcome after MI,” the researchers concluded. “These results suggest that contractile pattern may be an important determinant of the development of HF after MI, independently of global and regional contractile function.”
Shin S-H. Circulation. 2010;121:1096-1103.
 |
Follow CardiologyToday.com on Twitter. |