Istituto di Fisiologia Clinica     
Masci P. G., Ganame J., Francone M., Desmet W., Lorenzoni V., Iacucci I., Barison A., Carbone I., Lombardi M., Agati L., Janssens S., Bogaert J. Relationship between location and size of myocardial infarction and their reciprocal influences on post-infarction left ventricular remodelling. In: European Heart Journal, vol. 32 (13) pp. 1640 - 8. Oxford Journals, 2011.
AIMS: To assess the intricate relationship between myocardial infarction (MI) location and size and their reciprocal influences on post-infarction left ventricular (LV) remodelling. METHODS AND RESULTS: A cohort of 260 reperfused ST-segment elevation MI patients was prospectively studied with cardiovascular magnetic resonance at 1 week (baseline) and 4 months (follow-up). Area at risk (AAR) and MI size were quantified by T2-weighted and late-gadolinium enhancement imaging, respectively. Adverse LV remodelling was defined as an increase in LV end-systolic volume ≥15% at follow-up. One hundred and twenty-seven (49%) patients had anterior MI and 133 (51%) patients had non-anterior MI. Although the degree of myocardial salvage was similar between groups (P = 0.74), anterior MI patients had larger AAR and MI size than non-anterior MI patients yielding worse regional and global LV function at baseline and follow-up. At univariable analysis, anterior MI was associated with increased risk of adverse LV remodelling (P = 0.017) and lower LV ejection fraction (EF) at follow-up (P = 0.001), but not when accounted for baseline MI size. Accordingly, at multivariable analysis, baseline MI size but not its location was an independent predictor of adverse LV remodelling (odds ratio =1.061, P < 0.001) and EF at follow-up (β-coefficient = -0.255, P < 0.001). CONCLUSION: Anterior MI patients experience more pronounced post-infarction LV remodelling and dysfunction than non-anterior MI patients due to a greater magnitude of irreversible ischaemic LV damage without any independent contribution of MI location.
DOI: 10.1093/eurheartj/ehr064
Subject myocardial infarction
myocardial infarction

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