Korean Circ J.  2011 Mar;41(3):124-129. 10.4070/kcj.2011.41.3.124.

Dyslipidemia, Low Left Ventricular Ejection Fraction and High Wall Motion Score Index Are Predictors of Progressive Left Ventricular Dilatation After Acute Myocardial Infarction

• Yoon HJ
• Jeong MH
• Bae JH
• Kim KH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 2225125
• DOI: http://doi.org/10.4070/kcj.2011.41.3.124

Abstract

BACKGROUND AND OBJECTIVES
Left ventricular (LV) remodeling is a heterogeneous process, involving both infarcted and non-infarcted zones, which affects wall thickness and chamber size, shape and function.
SUBJECTS AND METHODS
A total of 758 consecutive patients (62.8+/-12.0 years, 539 males) with acute myocardial infarction (AMI), who were examined by echocardiography at admission and after 6 months. An increase in LV end-diastolic volume index >10% was defined as a progressive LV dilation. They were divided into two groups according to the extent of progressive LV dilatation during 6 months. Group I with progressive LV dilatation (n=154, 61.4+/-11.0 years, 110 males) vs. group II without LV dilatation (n=604, 64.1+/-12.0 years, 429 males).
RESULTS
The age and gender were no significant differences between two groups. The levels of glucose, creatinine, maximal creatine kinase (CK), CK-MB, troponin T and I were significantly increased in group I than in group II (p<0.05). Low ejection fraction (EF) and high wall motion score index (WMSI) were more common in group I than in group II (p<0.05). The presence of dyslipidemia {odds ratio (OR); 1.559, confidence interval (CI); 1.035-2.347, p=0.03}, low EF less than 45% (OR; 3.328, CI 2.099-5.276, p<0.01) and high WMSI above 1.5 (OR; 3.328, CI 2.099-5.276, p<0.01) were sig-nificant independent predictors of progressive LV dilatation by multivariate analysis.
CONCLUSION
Dyslipidemia, decreased systolic function and high WMSI were independent predictors of LV remodeling process in patients with AMI.

Keyword

Myocardial infarction; Heart failure; Prognosis

MeSH Terms

Creatine Kinase
Creatinine
Dilatation
Dyslipidemias
Echocardiography
Glucose
Heart Failure
Humans
Myocardial Infarction
Prognosis
Stroke Volume
Troponin T
Creatine Kinase
Creatinine
Glucose
Troponin T

Figure

• 

  Fig. 1 A: left ventricular end diastolic volume (LVEDV) and end systolic volume (LVESV) at admission and 6-month were significantly increased in group I, and not in group II (black line: group I; dot line: group II; triangle: LVEDV; circle: LVESV). B: serial changes of left ventricular ejection fraction (LVEF) at admission and 6-month showed decreased LVEF in group I and no significant change in group II (black line: group I; dot line: group II). C: serial changes of total wall motion score (TWMS) at admission and 6-month demonstrated decreased TWMS in group II and no significant change in group I (black line: group I; dot line: group II).

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