BACKGROUND: The prognostic impact of left ventricular (LV) geometry on cardiovascular risk for patients with a first, uncomplicated acute myocardial infarction (AMI), and echocardiographic ejection fraction > or =50% has not been well described. METHODS AND RESULTS: Accordingly, 111 AMI consecutive patients (mean age 59.3+/-10 years) performed echocardiographic examination at predischarge. LV mass was calculated by means of Devereux's formula and subsequently indexed by body surface area. Fifty-three patients had LV hypertrophy and 58 patients had normal LV mass. The two groups were homogeneous for demographic, clinical and angiographic variables as well as for the incidence of residual ischemia on predischarge stress testing. During follow-up period there were 24 cardiac events (cardiac death, unstable angina and non-fatal reinfarction) in the 53 patients with LV hypertrophy and only four events in the remaining 58 patients without LV hypertrophy (RR=2.45; CI=1.76-3.41; P<0.0001). The patients with concentric LV hypertrophy showed a higher incidence of events (64%) than patients with eccentric LV hypertrophy (32%, P<0. 05) and patients with normal geometry and mass (6%, P<0.0001). Multivariate Cox regression model identified concentric geometry as the most powerful predictor of combined end-points (chi(2)=32.7, P<0. 0001). CONCLUSIONS: An increased LV mass and concentric geometry resulted important independent markers of an adverse outcome in patients with a first, uncomplicated myocardial infarction and good LV function.
BACKGROUND: The prognostic impact of left ventricular (LV) geometry on cardiovascular risk for patients with a first, uncomplicated acute myocardial infarction (AMI), and echocardiographic ejection fraction > or =50% has not been well described. METHODS AND RESULTS: Accordingly, 111 AMI consecutive patients (mean age 59.3+/-10 years) performed echocardiographic examination at predischarge. LV mass was calculated by means of Devereux's formula and subsequently indexed by body surface area. Fifty-three patients had LV hypertrophy and 58 patients had normal LV mass. The two groups were homogeneous for demographic, clinical and angiographic variables as well as for the incidence of residual ischemia on predischarge stress testing. During follow-up period there were 24 cardiac events (cardiac death, unstable angina and non-fatal reinfarction) in the 53 patients with LV hypertrophy and only four events in the remaining 58 patients without LV hypertrophy (RR=2.45; CI=1.76-3.41; P<0.0001). The patients with concentric LV hypertrophy showed a higher incidence of events (64%) than patients with eccentric LV hypertrophy (32%, P<0. 05) and patients with normal geometry and mass (6%, P<0.0001). Multivariate Cox regression model identified concentric geometry as the most powerful predictor of combined end-points (chi(2)=32.7, P<0. 0001). CONCLUSIONS: An increased LV mass and concentric geometry resulted important independent markers of an adverse outcome in patients with a first, uncomplicated myocardial infarction and good LV function.
Authors: Raghava S Velagaleti; Philimon Gona; Michael J Pencina; Jayashri Aragam; Thomas J Wang; Daniel Levy; Ralph B D'Agostino; Douglas S Lee; William B Kannel; Emelia J Benjamin; Ramachandran S Vasan Journal: Am J Cardiol Date: 2013-10-04 Impact factor: 2.778
Authors: Mouaz H Al-Mallah; Khurram Nasir; Ronit Katz; Joao A Lima; David A Bluemke; Roger S Blumenthal; Songshou Mao; W Gregory Hundley; Matthew J Budoff Journal: Am J Cardiol Date: 2013-10-08 Impact factor: 2.778
Authors: Rodrigo Fernández-Jiménez; Jacobo Silva; Sara Martínez-Martínez; M Dolores López-Maderuelo; Mario Nuno-Ayala; José Manuel García-Ruiz; Ana García-Álvarez; Leticia Fernández-Friera; Tech Gonzalo Pizarro; Jaime García-Prieto; David Sanz-Rosa; Gonzalo López-Martin; Antonio Fernández-Ortiz; Carlos Macaya; Valentin Fuster; Juan Miguel Redondo; Borja Ibanez Journal: J Am Heart Assoc Date: 2015-01-21 Impact factor: 5.501
Authors: Tom Hendriks; Minke H T Hartman; Pieter J J Vlaar; Niek H J Prakken; Yldau M Y van der Ende; Chris P H Lexis; Dirk J van Veldhuisen; Iwan C C van der Horst; Erik Lipsic; Robin Nijveldt; Pim van der Harst Journal: Int J Cardiovasc Imaging Date: 2017-04-07 Impact factor: 2.357