Different patterns of left ventricular enlargement and long-term prognosis after reperfused acute myocardial infarction

Summary Background Dilation of end-systolic and end-diastolic volumes (ESV, EDV) has been used to define left ventricular remodelling after acute myocardial infarction (MI), but the prognostic significance of different enlargement patterns has not been evaluated fully. Aim To analyse the evolution o...

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Veröffentlicht in:Archives of cardiovascular diseases 2009-08, Vol.102 (8), p.599-605
Hauptverfasser: Lipiecki, Janusz, Durel, Nicolas, Ernande, Laura, Monzy, Séverine, Muliez, Aurelien, Ponsonnaille, Jean
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container_end_page 605
container_issue 8
container_start_page 599
container_title Archives of cardiovascular diseases
container_volume 102
creator Lipiecki, Janusz
Durel, Nicolas
Ernande, Laura
Monzy, Séverine
Muliez, Aurelien
Ponsonnaille, Jean
description Summary Background Dilation of end-systolic and end-diastolic volumes (ESV, EDV) has been used to define left ventricular remodelling after acute myocardial infarction (MI), but the prognostic significance of different enlargement patterns has not been evaluated fully. Aim To analyse the evolution of left ventricular volumes and parameters of global and regional contractility and their correlations with long-term prognosis in patients treated by angioplasty in the acute phase of MI. Methods Seventy-four patients (mean age 56 ± 13 years; 77% men), treated successfully by angioplasty in the acute phase of MI, were included prospectively. Significant enlargement of left ventricular volumes was defined as a greater than 20% increase between acute phase and 6-month control, assessed by contrast ventriculography. Clinical follow-up was obtained for all patients at 82 ± 19 months. Results Four groups were identified based on volume evolution: Group I ( n = 29, 39%; no volume enlargement); Group II ( n = 8, 11%; isolated EDV enlargement); Group III ( n = 10, 14%; isolated ESV enlargement); Group IV ( n = 27, 36%; ESV plus EDV enlargement). Global left ventricular ejection fraction increased in Groups I ( p = 0.001) and II ( p = 0.037), but decreased in Groups III ( p = 0.0002) and IV ( p = 0.019). The 6-year event-free survival rate was significantly ( p = 0.0039) better in Groups I and II (100%) than in Groups III and IV (80 and 78%, respectively). Conclusion ESV enlargement in patients with reperfused acute MI impacts negatively on long-term prognosis, while isolated EDV enlargement does not.
doi_str_mv 10.1016/j.acvd.2009.04.012
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Aim To analyse the evolution of left ventricular volumes and parameters of global and regional contractility and their correlations with long-term prognosis in patients treated by angioplasty in the acute phase of MI. Methods Seventy-four patients (mean age 56 ± 13 years; 77% men), treated successfully by angioplasty in the acute phase of MI, were included prospectively. Significant enlargement of left ventricular volumes was defined as a greater than 20% increase between acute phase and 6-month control, assessed by contrast ventriculography. Clinical follow-up was obtained for all patients at 82 ± 19 months. Results Four groups were identified based on volume evolution: Group I ( n = 29, 39%; no volume enlargement); Group II ( n = 8, 11%; isolated EDV enlargement); Group III ( n = 10, 14%; isolated ESV enlargement); Group IV ( n = 27, 36%; ESV plus EDV enlargement). Global left ventricular ejection fraction increased in Groups I ( p = 0.001) and II ( p = 0.037), but decreased in Groups III ( p = 0.0002) and IV ( p = 0.019). The 6-year event-free survival rate was significantly ( p = 0.0039) better in Groups I and II (100%) than in Groups III and IV (80 and 78%, respectively). Conclusion ESV enlargement in patients with reperfused acute MI impacts negatively on long-term prognosis, while isolated EDV enlargement does not.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2009.04.012</identifier><identifier>PMID: 19786263</identifier><language>eng</language><publisher>Amsterdam: Elsevier Masson SAS</publisher><subject>Acute myocardial infarction ; Adult ; Aged ; Angioplasty ; Atherosclerosis (general aspects, experimental research) ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiovascular ; Coronary heart disease ; Disease-Free Survival ; Female ; Heart ; Heart Ventricles - pathology ; Heart Ventricles - physiopathology ; Humans ; Infarctus du myocarde aigu ; Internal Medicine ; Kaplan-Meier Estimate ; Left ventricular remodeling ; Long-term prognosis ; Male ; Medical sciences ; Middle Aged ; Myocardial Contraction ; Myocardial Infarction - mortality ; Myocardial Infarction - pathology ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocarditis. 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Aim To analyse the evolution of left ventricular volumes and parameters of global and regional contractility and their correlations with long-term prognosis in patients treated by angioplasty in the acute phase of MI. Methods Seventy-four patients (mean age 56 ± 13 years; 77% men), treated successfully by angioplasty in the acute phase of MI, were included prospectively. Significant enlargement of left ventricular volumes was defined as a greater than 20% increase between acute phase and 6-month control, assessed by contrast ventriculography. Clinical follow-up was obtained for all patients at 82 ± 19 months. Results Four groups were identified based on volume evolution: Group I ( n = 29, 39%; no volume enlargement); Group II ( n = 8, 11%; isolated EDV enlargement); Group III ( n = 10, 14%; isolated ESV enlargement); Group IV ( n = 27, 36%; ESV plus EDV enlargement). Global left ventricular ejection fraction increased in Groups I ( p = 0.001) and II ( p = 0.037), but decreased in Groups III ( p = 0.0002) and IV ( p = 0.019). The 6-year event-free survival rate was significantly ( p = 0.0039) better in Groups I and II (100%) than in Groups III and IV (80 and 78%, respectively). Conclusion ESV enlargement in patients with reperfused acute MI impacts negatively on long-term prognosis, while isolated EDV enlargement does not.</description><subject>Acute myocardial infarction</subject><subject>Adult</subject><subject>Aged</subject><subject>Angioplasty</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Coronary heart disease</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Ventricles - pathology</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Infarctus du myocarde aigu</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Left ventricular remodeling</subject><subject>Long-term prognosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Contraction</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Pronostic à long terme</subject><subject>Prospective Studies</subject><subject>Remodelage du ventricule gauche</subject><subject>Stroke Volume</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left</subject><subject>Ventricular Remodeling</subject><issn>1875-2136</issn><issn>1875-2128</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9rFDEUxwdRbK3-Ax4kF-lpxvyYzExABGmtCgUP1XN4TV6WrDPJmsys7H_fDLu04MFLEh6f9_Llw6uqt4w2jLLuw7YBs7cNp1Q1tG0o48-qczb0suaMD88f36I7q17lvKW0433fvazOmOqHjnfivPp77Z3DhGEmO5hnTCGT6MiIbib7Uk3eLCMkgqGcG5xWEIIlYwybuuAT2aW4CTH7TMCVAkm4w-SWjJaAWWYk0yEaSNbDSHxwkMzsY3hdvXAwZnxzui-qXzdffl59q29_fP1-9fm2Nu3QzrVFxxEsSiMd651S91YK1SJIy5mEQQxMciuMsWJAKntle66oVZKBRFHYi-ryOLfE_LNgnvXks8FxhIBxyboXLe0E5aKQ_EiaFHNO6PQu-QnSQTOqV996q1ffevWtaauL79L07jR-uZ_QPrWcBBfg_QmAbGB0CYLx-ZHjTHWqZ2vOj0cOi4y9x6Sz8RgMWp_QzNpG__8cn_5pN6MPvvz4Gw-Yt3FJoWjWTGeuqb5bN2NdDKooZYoq8QBAWLY1</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Lipiecki, Janusz</creator><creator>Durel, Nicolas</creator><creator>Ernande, Laura</creator><creator>Monzy, Séverine</creator><creator>Muliez, Aurelien</creator><creator>Ponsonnaille, Jean</creator><general>Elsevier Masson SAS</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Different patterns of left ventricular enlargement and long-term prognosis after reperfused acute myocardial infarction</title><author>Lipiecki, Janusz ; Durel, Nicolas ; Ernande, Laura ; Monzy, Séverine ; Muliez, Aurelien ; Ponsonnaille, Jean</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-def2eade5c5f17f99bd5394ea5d215a838152d3ccd38e0579d7290d951a5e3d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acute myocardial infarction</topic><topic>Adult</topic><topic>Aged</topic><topic>Angioplasty</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Coronary heart disease</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Ventricles - pathology</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Infarctus du myocarde aigu</topic><topic>Internal Medicine</topic><topic>Kaplan-Meier Estimate</topic><topic>Left ventricular remodeling</topic><topic>Long-term prognosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Contraction</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Pronostic à long terme</topic><topic>Prospective Studies</topic><topic>Remodelage du ventricule gauche</topic><topic>Stroke Volume</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lipiecki, Janusz</creatorcontrib><creatorcontrib>Durel, Nicolas</creatorcontrib><creatorcontrib>Ernande, Laura</creatorcontrib><creatorcontrib>Monzy, Séverine</creatorcontrib><creatorcontrib>Muliez, Aurelien</creatorcontrib><creatorcontrib>Ponsonnaille, Jean</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lipiecki, Janusz</au><au>Durel, Nicolas</au><au>Ernande, Laura</au><au>Monzy, Séverine</au><au>Muliez, Aurelien</au><au>Ponsonnaille, Jean</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Different patterns of left ventricular enlargement and long-term prognosis after reperfused acute myocardial infarction</atitle><jtitle>Archives of cardiovascular diseases</jtitle><addtitle>Arch Cardiovasc Dis</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>102</volume><issue>8</issue><spage>599</spage><epage>605</epage><pages>599-605</pages><issn>1875-2136</issn><eissn>1875-2128</eissn><abstract>Summary Background Dilation of end-systolic and end-diastolic volumes (ESV, EDV) has been used to define left ventricular remodelling after acute myocardial infarction (MI), but the prognostic significance of different enlargement patterns has not been evaluated fully. Aim To analyse the evolution of left ventricular volumes and parameters of global and regional contractility and their correlations with long-term prognosis in patients treated by angioplasty in the acute phase of MI. Methods Seventy-four patients (mean age 56 ± 13 years; 77% men), treated successfully by angioplasty in the acute phase of MI, were included prospectively. Significant enlargement of left ventricular volumes was defined as a greater than 20% increase between acute phase and 6-month control, assessed by contrast ventriculography. Clinical follow-up was obtained for all patients at 82 ± 19 months. Results Four groups were identified based on volume evolution: Group I ( n = 29, 39%; no volume enlargement); Group II ( n = 8, 11%; isolated EDV enlargement); Group III ( n = 10, 14%; isolated ESV enlargement); Group IV ( n = 27, 36%; ESV plus EDV enlargement). Global left ventricular ejection fraction increased in Groups I ( p = 0.001) and II ( p = 0.037), but decreased in Groups III ( p = 0.0002) and IV ( p = 0.019). The 6-year event-free survival rate was significantly ( p = 0.0039) better in Groups I and II (100%) than in Groups III and IV (80 and 78%, respectively). Conclusion ESV enlargement in patients with reperfused acute MI impacts negatively on long-term prognosis, while isolated EDV enlargement does not.</abstract><cop>Amsterdam</cop><pub>Elsevier Masson SAS</pub><pmid>19786263</pmid><doi>10.1016/j.acvd.2009.04.012</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Acute myocardial infarction
Adult
Aged
Angioplasty
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular
Coronary heart disease
Disease-Free Survival
Female
Heart
Heart Ventricles - pathology
Heart Ventricles - physiopathology
Humans
Infarctus du myocarde aigu
Internal Medicine
Kaplan-Meier Estimate
Left ventricular remodeling
Long-term prognosis
Male
Medical sciences
Middle Aged
Myocardial Contraction
Myocardial Infarction - mortality
Myocardial Infarction - pathology
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Myocarditis. Cardiomyopathies
Pronostic à long terme
Prospective Studies
Remodelage du ventricule gauche
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Function, Left
Ventricular Remodeling
title Different patterns of left ventricular enlargement and long-term prognosis after reperfused acute myocardial infarction
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