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Hassell ME, Vlastra W, Robbers L, et al. Long-term left ventricular remodelling after revascularisation for ST-segment elevation myocardial infarction as assessed by cardiac magnetic resonance imaging. Open Heart. 2017;4(1):e000569doi: 10.1136/openhrt-2016-000569.
Hassell, M. E., Vlastra, W., Robbers, L., Hirsch, A., Nijveldt, R., Tijssen, J. G., van Rossum, A. C., Zijlstra, F., Piek, J. J., & Delewi, R. (2017). Long-term left ventricular remodelling after revascularisation for ST-segment elevation myocardial infarction as assessed by cardiac magnetic resonance imaging. Open heart, 4(1), e000569. https://doi.org/10.1136/openhrt-2016-000569
Hassell, Mariella Ecj, et al. "Long-term left ventricular remodelling after revascularisation for ST-segment elevation myocardial infarction as assessed by cardiac magnetic resonance imaging." Open heart vol. 4,1 (2017): e000569. doi: https://doi.org/10.1136/openhrt-2016-000569
Hassell ME, Vlastra W, Robbers L, Hirsch A, Nijveldt R, Tijssen JG, van Rossum AC, Zijlstra F, Piek JJ, Delewi R. Long-term left ventricular remodelling after revascularisation for ST-segment elevation myocardial infarction as assessed by cardiac magnetic resonance imaging. Open Heart. 2017 May 22;4(1):e000569. doi: 10.1136/openhrt-2016-000569. eCollection 2017. PMID: 28861274; PMCID: PMC5577529.
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Open Heart. 2017 May 22;4(1):e000569. doi: 10.1136/openhrt-2016-000569. eCollection 2017.

Long-term left ventricular remodelling after revascularisation for ST-segment elevation myocardial infarction as assessed by cardiac magnetic resonance imaging.

Open heart

Mariella Ecj Hassell, Wieneke Vlastra, Lourens Robbers, Alexander Hirsch, Robin Nijveldt, Jan Gp Tijssen, Albert C van Rossum, Felix Zijlstra, Jan J Piek, Ronak Delewi

Affiliations

  1. Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  2. Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
  3. Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
  4. Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

PMID: 28861274 PMCID: PMC5577529 DOI: 10.1136/openhrt-2016-000569

Abstract

OBJECTIVE: Left ventricular remodelling following a ST-segment elevated myocardial infarction (STEMI) is an adaptive response to maintain the cardiac output despite myocardial tissue loss. Limited studies have evaluated long term ventricular function using cardiac magnetic resonance imaging (CMR) after STEMI.

METHODS: Study population consisted of 155 primary percutaneous coronary intervention treated first STEMI patients. CMR was performed at 4±2 days, 4 months and 24 months follow-up. Patients were treated with beta-blockers, ACE-inhibitors or AT-II- inhibitors, statins and dual antiplatelet according to current international guidelines.

RESULTS: Mean left ventricular ejection fraction (LVEF) at baseline was 44%±8%. Twenty-one per cent of the study population had an increase of more than 5.0% after 4 months of follow-up and 21% of the cohort had a decrease of more than 5.0%. Patients with long-term LVEF deterioration have significantly larger end-systolic volumes than patients with improvement of LVEF (61±23 mL/m

CONCLUSION: Contrary to previous studies, we demonstrate that myocardial remodelling after STEMI is a long-term process. Long-term LVEF deterioration is characterised by an increase in end-systolic volume and less wall thickening in the remote zones. Patients with LVEF improvement exhibit an increase in left ventricular wall thickening both in the infarct as well as in the remote zones.

TRIAL REGISTRATION: The HEBE study is registered in The Netherlands Trial Register #NTR166 (www.trialregister.nl) and the International Standard Randomised Controlled Trial, #ISRCTN95796863 (https://c-d-qn9pqajji.sec.amc.nl).

Keywords: MRI; STEMI; cardiac remodelling

Conflict of interest statement

Competing interests: None declared.

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