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首页> 外文期刊>Advances in Interventional Cardiology: Postepy w Kardiologii Interwencyjnej >Left ventricular reverse remodeling in patients with anterior wall ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention
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Left ventricular reverse remodeling in patients with anterior wall ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention

机译：原发性经皮冠状动脉介入治疗对前壁ST段抬高急性心肌梗死患者的左心室逆重塑

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Introduction The study aimed to evaluate the prevalence and predictors of left ventricular (LV) reverse remodeling and its impact on long-term prognosis in patients with anterior ST-segment elevation myocardial infarction (STEMI). Aim To assess the percentage of reverse remodeling and its prognostic factors in anterior STEMI patients. Material and methods This observational study included 40 patients with first ever STEMI of the anterior wall. LV reverse remodeling was defined as the reduction of left ventricular end-systolic volume (?LVESV) by ≥ 10% in 3D transthoracic echocardiography (3D-TTE) at 3-month follow-up. 3D-TTE and speckle tracking imaging were performed during index hospitalization, while 3D-TTE and cardiac magnetic resonance (CMR) were performed at 3 months following the procedure. Patients were followed up for a?median time of 3.4 years in order to evaluate major adverse cardiovascular events. Results Left ventricular reverse remodeling at 3-month follow-up was confirmed in 15 (37.5%) patients. The presence of reverse remodeling was predicted by lower troponin levels (unit OR = 0.86, p = 0.02), lower sum of ST-segment elevations before (unit OR = 0.87, p = 0.03) and after PCI (unit OR = 0.40, p = 0.03), lower maximal ST-segment elevation after PCI (unit OR = 0.01, p = 0.03), lower wall motion score index (unit OR 0.40, p = 0.03) and more negative anterior wall global longitudinal strain (unit OR = 0.88, p = 0.045). Nine MACE were reported in the without reverse remodeling group only. Non-significantly better event-free survival in the reverse remodeling group was demonstrated (log-rank p = 0.07). Conclusions Development of reverse modeling in patients with optimal revascularization and tailored pharmacotherapy is relatively high. Further studies are warranted in order to adjudicate its prognostic role for the prediction of adverse events.
机译：引言这项研究旨在评估左心室前段抬高型心肌梗死（STEMI）患者左心室（LV）逆向重构的发生率和预测因素及其对长期预后的影响。目的评估STEMI前期患者逆向重构的百分比及其预后因素。材料和方法这项观察性研究纳入了40例有史以来首次发生前壁STEMI的患者。左心室逆向重构定义为在3个月的随访中3D经胸超声心动图（3D-TTE）可使左心室收缩末期容积（？LVESV）降低≥10％。在索引住院期间进行3D-TTE和散斑跟踪成像，而在术后3个月进行3D-TTE和心脏磁共振（CMR）。对患者进行了3.4年的随访，以评估主要的不良心血管事件。结果在15例（37.5％）的患者中，在3个月的随访中确认了左心室逆重塑。肌钙蛋白水平较低（单位OR = 0.86，p = 0.02），PCI之前和之后ST段抬高的总和较低（单位OR = 0.87，p = 0.03）和PCI之后（单位OR = 0.40，p），可以预测存在反向重构= 0.03），PCI后最大ST段抬高较低（单位OR = 0.01，p = 0.03），壁运动评分指数较低（单位OR 0.40，p = 0.03）和更大的负前壁整体纵向应变（单位OR = 0.88） ，p = 0.045）。仅在无逆转重构组中报告了9个MACE。反向重构组的无事件生存率显着提高（对数秩p = 0.07）。结论最佳血运重建和定制药物治疗的逆向模型开发相对较高。为了确定其在不良事件预测中的预后作用，有必要做进一步的研究。

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