Abstract
Left ventricular (LV) remodeling after ST-segment elevation myocardial infarction (STEMI) is correlated with increased mortality and heart failure. Most studies assessing LV remodeling were performed using two-dimensional echocardiography (2DE). Cardiovascular magnetic resonance (CMR) and three-dimensional echocardiography (3DE) are more accurate than 2DE to assess LV volumes and thus to screen LV remodeling. The aim of the study is to evaluate LV remodeling, 1 year after STEMI, with three different modalities of imaging: 2DE, 3DE and CMR. This monocentric retrospective study enrolled all STEMI patients without history of cardiomyopathy or contraindication of CMR. Baseline and 12-months 2DE, 3DE and CMR were analyzed. LV remodeling was defined as an increase of LV end-diastolic volume (LVEDV) ≥ 20% in 2DE and ≥ 12% in CMR. Both LVEDV cut-off value of 20% and 12% were analyzed in 3DE. Fifty-three patients, mean age 58 ± 11 years, 74% men, were studied. With 2DE, 18 (37%) patients demonstrated LV remodeling, 14 (27%) patients with CMR, 7 (25%) patients with 3DE (20% cut-off) and 10 (36%) (12% cut-off). No significant association was found in LV remodeling assessment between 2DE and CMR ( P = 0.49), 2DE and 3DE ( P = 0.12) and 3DE and CMR ( P = 0.77). Concordance of remodeling patients was 60% between 2DE and CMR, 70% (20% cut-off) and 67% (12% cut-off) between 2DE and 3DE and 59% (12% cut-off) between 3DE and CMR. Whereas 2DE revealed that more than one third of STEMI patients demonstrated LV remodeling, CMR demonstrated it in only 27% of patients. Cardiac imaging modalities are therefore not interchangeable to assess LV remodeling.
Published Version
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