Early predictors of the development of pathological postinfarction left ventricular remodeling

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Objective to assess the ability of standard echocardiography parameters and parameters of myocardial deformation on the 7th-9th day of the STEMI to predict the risk of pathological remodeling in the postinfarction period. Methods the study included 114 patients with ST-segment elevation myocardial infarction (STEMI) mean age was 52.3 ± 8.4 years, men prevailed 100 (88%). On the 7th-9th day, echocardiography has been performed using the MyLab device (Italy) with the determination of end-diastolic and systolic volume indices (EDVi, ESVi), left ventricular myocardial mass index (LVMI). Global longitudinal (GLS), circumferential (GCS) and radial (GRS) strain (-%) have been determined using X-Strain ™ software. The development of pathological left ventricular remodeling (an increase in EDVi of more than 20% and / or ESVi of more than 15% at any visit within 48 weeks) has been considered as the end point. Multivariate Cox regression analysis was performed by including significant variables from a one-dimensional model (p <0.05), taking into account the absence of correlations between them. Results within 48 weeks, 45 (39%) patients developed pathological postinfarction remodeling. The following strong and independent predictors of the pathological postinfarction remodeling were included in the multivariate predictive model: GLS - RR 0.799 (95% CI 0.735-0.868) (p = 0.001), GRS - 1.047 (95% CI 1.013-1.083) (p = 0.001), EDVi - RR 1.041 (95% CI 1.015-1.07) (p = 0.026). Chi-square model 30.02, p ˂ 0.0001. Maximum likelihood ratio 385. Conclusions a multivariate model including GLS, GRS, and EDVi parameters on the 7th-9th day of STEMI is able to predict the development of pathological remodeling in patients within 48 weeks of the postinfarction period.