Abstract
Cardiac dyssynchrony is common in advanced heart failure (HF), but the changes in cardiac synchrony after myocardial infarction (MI) have not been adequately descríbed.To study the relationship between cardiac synchrony and left ventricular remodeling after acute myocardial infarction.Forty nine patients aged 59+/-10 years (77% men) with a first episode of a ST segment elevation MI, were studied. Scintigraphic left ventricular function and synchrony analyses were performed at baseline and after a six months follow-up. Determinations were compared with 33 healthy subjects.At baseline, patients with MIhad a decreased left ventricular ejection fraction (LVEF) and significant dyssynchrony, when compared with controls. LVEF was 36.4%+/-10%, left ventricular end-diastolic volume (LVEDV) 127+/-38 mL, interventricular delay (IEV) 29+/-35 miliseconds (ms), and intraventricular delay (IAV), 234+/-89 ms. After 6 months, LVEF significantly improved (38%+/-10%, p =0.042) without significant changes in LVEDV (129+/-32 mL, p =0.97), IEV (24+/-17, p =0.96) or IAV (231+/-97, p =0.34). At baseline there were significant correlations between IAV and LVEF, and between IAV and LVEDV (r =0.48, p =0.001 and r =0.41, p =0.004, respectively). These correlations remained significant after 6 months. There was a positive correlation between IAV and LVEDV changes at six months (r =0.403, p =0.04).The development of cardiac dyssynchrony correlates with adverse left ventricular remodeling after MI .
Highlights
Cardiac dyssynchrony is common in advanced heart failure
Scintigraphic left ventricular function and synchrony analyses were performed at baseline
after a six months follow-up. Determinations were compared with 33 healthy subjects
Summary
Cardiac dyssynchrony is common in advanced heart failure (HF), but the changes in cardiac synchrony after myocardial infarction (MI) have not been adequately described. Results: At baseline, patients with MI had a decreased left ventricular ejection fraction (LVEF) and significant dyssynchrony, when compared with controls. La terapia de resincronización cardíaca (TRC) mejora la capacidad funcional, la función ventricular izquierda y el pronóstico en pacientes con IC con deterioro de capacidad funcional moderada a severa, QRS prolongado y disfunción sistólica del ventrículo izquierdo[2]. Posterior a un infarto agudo al miocardio (IAM) se produce una disociación en el tiempo de contracción de los distintos segmentos del ventrículo izquierdo contribuyendo al remodelado y disfunción ventricular izquierda[4]. Todos los pacientes recibieron el resto de la terapia médica recomendada para el manejo del IAM. En las mediciones basales de los pacientes con IAM hubo una correlación significativa entre el RIV y la FEVI y entre el RIV y la VFDVI (r = -0,48; p =0,001 y r =0,41; p =0,004, respectivamente). Características basales de los pacientes con infarto agudo al miocardio y sujetos controles
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