AIMS: Few data are available on the extent and prognostic value of reverse left ventricular remodelling (r-LVR) after ST-elevation acute myocardial infarction (STEMI). We sought to evaluate incidence, major determinants, and long-term clinical significance of r-LVR in a group of STEMI patients treated with primary percutaneous coronary intervention (PPCI). In particular, the role of preserved microvascular flow within the infarct zone in inducing r-LVR has been investigated. METHODS AND RESULTS: Serial echocardiograms (2DE) and myocardial contrast study were obtained within 24 h of coronary recanalization (T1) and at pre-discharge (T2) in 110 reperfused STEMI patients. Follow-up 2DE was scheduled after 6 months (T3). Two-year clinical follow-up was obtained. Reverse remodelling was defined as a reduction >10% in LV end-systolic volume (LVESV) at 6 months follow-up. r-LVR occurred in 39% of study population. At multivariable analysis, independent predictors of r-LVR were an effective microvascular reflow within the infarct zone, the in-hospital improvement of myocardial perfusion, an initial large LVESV, and a short time to reperfusion. Cox analysis identified r-LVR as the only independent predictor of 2-year event-free survival. Combined events rate was significantly higher among patients without compared to those with r-LVR (log-rank test P < 0.05). CONCLUSION: r-LVR frequently occurs in STEMI patients treated with PPCI and it is an important predictor of favourable long-term outcome. A preserved microvascular perfusion within the infarct zone is the major determinant of r-LVR

Funaro, S., La Torre, G., Madonna, M., Galiuto, L., Scarà, A., Labbadia, A., Canali, E., Mattatelli, A., Fedele, F., Alessandrini, F., Crea, F., Agati, L., Incidence, determinants, and prognostic value of reverse left ventricularremodelling after primary percutaneous coronary intervention: results of theAcute Myocardial Infarction Contrast Imaging (AMICI) multicenter study., <<EUROPEAN HEART JOURNAL>>, 2009; (Marzo): 566-575. [doi:10.1093/eurheartj/ehn529] [http://hdl.handle.net/10807/32873]

Incidence, determinants, and prognostic value of reverse left ventricular remodelling after primary percutaneous coronary intervention: results of the Acute Myocardial Infarction Contrast Imaging (AMICI) multicenter study.

Funaro, Stefania;La Torre, Giuseppe;Galiuto, Leonarda;Alessandrini, Francesco;Crea, Filippo;
2009

Abstract

AIMS: Few data are available on the extent and prognostic value of reverse left ventricular remodelling (r-LVR) after ST-elevation acute myocardial infarction (STEMI). We sought to evaluate incidence, major determinants, and long-term clinical significance of r-LVR in a group of STEMI patients treated with primary percutaneous coronary intervention (PPCI). In particular, the role of preserved microvascular flow within the infarct zone in inducing r-LVR has been investigated. METHODS AND RESULTS: Serial echocardiograms (2DE) and myocardial contrast study were obtained within 24 h of coronary recanalization (T1) and at pre-discharge (T2) in 110 reperfused STEMI patients. Follow-up 2DE was scheduled after 6 months (T3). Two-year clinical follow-up was obtained. Reverse remodelling was defined as a reduction >10% in LV end-systolic volume (LVESV) at 6 months follow-up. r-LVR occurred in 39% of study population. At multivariable analysis, independent predictors of r-LVR were an effective microvascular reflow within the infarct zone, the in-hospital improvement of myocardial perfusion, an initial large LVESV, and a short time to reperfusion. Cox analysis identified r-LVR as the only independent predictor of 2-year event-free survival. Combined events rate was significantly higher among patients without compared to those with r-LVR (log-rank test P < 0.05). CONCLUSION: r-LVR frequently occurs in STEMI patients treated with PPCI and it is an important predictor of favourable long-term outcome. A preserved microvascular perfusion within the infarct zone is the major determinant of r-LVR
2009
Inglese
Funaro, S., La Torre, G., Madonna, M., Galiuto, L., Scarà, A., Labbadia, A., Canali, E., Mattatelli, A., Fedele, F., Alessandrini, F., Crea, F., Agati, L., Incidence, determinants, and prognostic value of reverse left ventricularremodelling after primary percutaneous coronary intervention: results of theAcute Myocardial Infarction Contrast Imaging (AMICI) multicenter study., <<EUROPEAN HEART JOURNAL>>, 2009; (Marzo): 566-575. [doi:10.1093/eurheartj/ehn529] [http://hdl.handle.net/10807/32873]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/32873
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