Predictors Of Left Ventricular Remodelling In Patients With ST-Elevation Myocardial Infarction

Abstract

Background: Left ventricular (LV) remodelling is still the leading cause of heart failure (HF) and death in patients surviving ST-segment elevation myocardial infarction (STEMI). Despite improvement in treatments of STEMI yet the outcomes did not change and remodelling occur in about 30% of patients after STEMI. Predictors for LV remodelling are still under investigated, early prediction of LV remodelling is a necessity.Aims: We aimed to identify factors that help in early prediction of LV remodelling after STEMI using standard history, examination, laboratory results, echocardiographic study, and angiographic data collection.Patients and Methods: We included 107 patients with 1st acute STEMI treated by primary percutaneous coronary intervention (PCI) or by thrombolysis then PCI within 24 hours. Patients were divided into two groups according to remodelling after six months; defined as ≥20% increase in left ventricular end diastolic volume (LVEDV). Patients were subjected to history taking, cardiac examination, electrocardiography, standard investigations, echocardiography, and angiography with PCI. After 6 months another echocardiography was done.Results: There was statistically significant positive correlation between the study groups regarding; time till target treatment, hsTroponin T, sum of ST segment elevation, number of leads involved (p˂0.001), AST level (p˂0.031), initial LVEDV (p=0.003), initial presence of akinesia, and a negative correlation with myocardial blush grade (p˂0.001), All were independent predictors of remodelling. Conclusions: Time till target treatment, hsTroponin, AST, sum of ST segment elevation, number of leads involved, MBG score, initial LVEDV and initial presence of akinesia are independent predictor of LV remodelling