TY - JOUR
T1 - Association of left ventricular flow energetics with remodeling after myocardial infarction
T2 - New hemodynamic insights for left ventricular remodeling
AU - Demirkiran, Ahmet
AU - van der Geest, Rob J.
AU - Hopman, Luuk H. G. A.
AU - Robbers, Lourens F. H. J.
AU - Handoko, M. Louis
AU - Nijveldt, Robin
AU - Greenwood, John P.
AU - Plein, Sven
AU - Garg, Pankaj
N1 - Funding Information: This work was supported by the British Heart Foundation [ FS/10/62/28409 to S.P.]. This work was partly funded by Wellcome Trust grants ( 220703/Z/20/Z ). For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. Funding Information: We would like to thank Hans J. Berkhof (PhD, Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands) for his valuable contributions in the statistical analysis of the data. The first author, Ahmet Demirkiran has received a research grant from The European Association of Cardiovascular Imaging (EACVI). Funding Information: This work was supported by the British Heart Foundation [FS/10/62/28409 to S.P.]. This work was partly funded by Wellcome Trust grants (220703/Z/20/Z). For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.We would like to thank Hans J. Berkhof (PhD, Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands) for his valuable contributions in the statistical analysis of the data. The first author, Ahmet Demirkiran has received a research grant from The European Association of Cardiovascular Imaging (EACVI). Publisher Copyright: © 2022 The Authors
PY - 2022/11/15
Y1 - 2022/11/15
N2 - BACKGROUND: Myocardial infarction leads to complex changes in left ventricular (LV) hemodynamics. It remains unknown how four-dimensional acute changes in LV-cavity blood flow kinetic energy affects LV-remodeling. METHODS AND RESULTS: In total, 69 revascularised ST-segment elevation myocardial infarction (STEMI) patients were enrolled. All patients underwent cardiovascular magnetic resonance (CMR) examination within 2 days of the index event and at 3-month. CMR examination included cine, late gadolinium enhancement, and whole-heart four-dimensional flow acquisitions. LV volume-function, infarct size (indexed to body surface area), microvascular obstruction, mitral inflow, and blood flow KEi (kinetic energy indexed to end-diastolic volume) characteristics were obtained. Adverse LV-remodeling was defined and categorized according to increase in LV end-diastolic volume of at least 10%, 15%, and 20%. Twenty-four patients (35%) developed at least 10%, 17 patients (25%) at least 15%, 11 patients (16%) at least 20% LV-remodeling. Demographics and clinical history were comparable between patients with/without LV-remodeling. In univariable regression-analysis, A-wave KEi was associated with at least 10%, 15%, and 20% LV-remodeling (p = 0.03, p = 0.02, p = 0.02, respectively), whereas infarct size only with at least 10% LV-remodeling (p = 0.02). In multivariable regression-analysis, A-wave KEi was identified as an independent marker for at least 10%, 15%, and 20% LV-remodeling (p = 0.09, p < 0.01, p < 0.01, respectively), yet infarct size only for at least 10% LV-remodeling (p = 0.03). CONCLUSION: In patients with STEMI, LV hemodynamic assessment by LV blood flow kinetic energetics demonstrates a significant inverse association with adverse LV-remodeling. Late-diastolic LV blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling.
AB - BACKGROUND: Myocardial infarction leads to complex changes in left ventricular (LV) hemodynamics. It remains unknown how four-dimensional acute changes in LV-cavity blood flow kinetic energy affects LV-remodeling. METHODS AND RESULTS: In total, 69 revascularised ST-segment elevation myocardial infarction (STEMI) patients were enrolled. All patients underwent cardiovascular magnetic resonance (CMR) examination within 2 days of the index event and at 3-month. CMR examination included cine, late gadolinium enhancement, and whole-heart four-dimensional flow acquisitions. LV volume-function, infarct size (indexed to body surface area), microvascular obstruction, mitral inflow, and blood flow KEi (kinetic energy indexed to end-diastolic volume) characteristics were obtained. Adverse LV-remodeling was defined and categorized according to increase in LV end-diastolic volume of at least 10%, 15%, and 20%. Twenty-four patients (35%) developed at least 10%, 17 patients (25%) at least 15%, 11 patients (16%) at least 20% LV-remodeling. Demographics and clinical history were comparable between patients with/without LV-remodeling. In univariable regression-analysis, A-wave KEi was associated with at least 10%, 15%, and 20% LV-remodeling (p = 0.03, p = 0.02, p = 0.02, respectively), whereas infarct size only with at least 10% LV-remodeling (p = 0.02). In multivariable regression-analysis, A-wave KEi was identified as an independent marker for at least 10%, 15%, and 20% LV-remodeling (p = 0.09, p < 0.01, p < 0.01, respectively), yet infarct size only for at least 10% LV-remodeling (p = 0.03). CONCLUSION: In patients with STEMI, LV hemodynamic assessment by LV blood flow kinetic energetics demonstrates a significant inverse association with adverse LV-remodeling. Late-diastolic LV blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling.
KW - Kinetic energy
KW - Left ventricular remodeling
KW - ST-segment elevation myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85138459421&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijcard.2022.08.040
DO - https://doi.org/10.1016/j.ijcard.2022.08.040
M3 - Article
C2 - 36007668
SN - 0167-5273
VL - 367
SP - 105
EP - 114
JO - International journal of cardiology
JF - International journal of cardiology
ER -