Remote zone extracellular volume and left ventricular remodeling in survivors of st-elevation myocardial infarction

Carberry, J. et al. (2016) Remote zone extracellular volume and left ventricular remodeling in survivors of st-elevation myocardial infarction. Hypertension, 68(2), pp. 385-391. (doi:10.1161/HYPERTENSIONAHA.116.07222) (PMID:27354423) (PMCID:PMC4956675)

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Abstract

The natural history and pathophysiological significance of tissue remodeling in the myocardial remote zone after acute ST-elevation myocardial infarction (STEMI) is incompletely understood. Extracellular volume (ECV) in myocardial regions of interest can now be measured with cardiac magnetic resonance imaging. Patients who sustained an acute STEMI were enrolled in a cohort study (BHF MR-MI [British Heart Foundation Magnetic Resonance Imaging in Acute ST-Segment Elevation Myocardial Infarction study]). Cardiac magnetic resonance was performed at 1.5 Tesla at 2 days and 6 months post STEMI. T1 modified Look-Locker inversion recovery mapping was performed before and 15 minutes after contrast (0.15 mmol/kg gadoterate meglumine) in 140 patients at 2 days post STEMI (mean age: 59 years, 76% male) and in 131 patients at 6 months post STEMI. Remote zone ECV was lower than infarct zone ECV (25.6±2.8% versus 51.4±8.9%; P<0.001). In multivariable regression, left ventricular ejection fraction was inversely associated with remote zone ECV (P<0.001), and diabetes mellitus was positively associated with remote zone ECV (P=0.010). No ST-segment resolution (P=0.034) and extent of ischemic area at risk (P<0.001) were multivariable associates of the change in remote zone ECV at 6 months (ΔECV). ΔECV was a multivariable associate of the change in left ventricular end-diastolic volume at 6 months (regression coefficient [95% confidence interval]: 1.43 (0.10–2.76); P=0.036). ΔECV is implicated in the pathophysiology of left ventricular remodeling post STEMI, but because the effect size is small, ΔECV has limited use as a clinical biomarker of remodeling.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Welsh, Dr Paul and Eteiba, Dr H and Carrick, Dr David and Petrie, Professor Mark and Rauhalammi, Mr Samuli and Oldroyd, Dr Keith and Haig, Dr Caroline and Sattar, Professor Naveed and Ford, Professor Ian and Mordi, Dr Ify and Radjenovic, Dr Aleksandra and Ahmed, Mr Nadeem and Hood, Dr Stuart
Authors: Carberry, J., Carrick, D., Haig, C., Rauhalammi, S. M., Ahmed, N., Mordi, I., McEntegart, M., Petrie, M. C., Eteiba, H., Hood, S., Watkins, S., Lindsay, M., Davie, A., Mahrous, A., Ford, I., Sattar, N., Welsh, P., Radjenovic, A., Oldroyd, K. G., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Hypertension
Publisher:American Heart Association
ISSN:0194-911X
ISSN (Online):1524-4563
Published Online:27 June 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Hypertension 68(2): 385-391
Publisher Policy:Reproduced under a Creative Commons License
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
544551Validation and significance of myocardial haemorrhage revealed by "bright blood" T2-weighted MRI in heart attack survivors: a prospective cohort study.Colin BerryBritish Heart Foundation (BHF)PG/11/2/28474RI CARDIOVASCULAR & MEDICAL SCIENCES
612031Cardiac biomarkers and CVD risk screening: a cost-effective public health measure?Paul WelshBritish Heart Foundation (BHF)FS/12/62/29889RI CARDIOVASCULAR & MEDICAL SCIENCES