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Demirkiran, Ahmet, van der Geest, Rob J., Hopman, Luuk H. G. A., Robbers, Lourens F. H. J., Handoko, M. Louis, Nijveldt, Robin, Greenwood, John P., Plein, Sven and Garg, Pankaj 
ORCID: https://orcid.org/0000-0002-5483-169X
(2022)
Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling.
International Journal of Cardiology, 367.
pp. 105-114.
ISSN 1874-1754
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Abstract
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.
| Item Type: | Article |
|---|---|
| Additional Information: | 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). Rights retention statement: 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. |
| Uncontrolled Keywords: | kinetic energy,left ventricular remodeling,st-segment elevation myocardial infarction,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2705 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 24 Aug 2022 14:30 |
| Last Modified: | 25 Sep 2024 16:40 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/87601 |
| DOI: | 10.1016/j.ijcard.2022.08.040 |
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