Asynergy of the Noninfarcted Left Ventricular Inferior Wall in Anterior Wall Acute Myocardial Infarction Secondary to Isolated Occlusion of the Left Anterior Descending Artery

Relationship between Myocardial Edema and Regional Myocardial Function after Reperfused Acute Myocardial Infarction: An MR Imaging Study

“…Remote myocardial hypertrophy and hyperkinesis have been reported after AMI (29). Studies in humans (30,31) have shown compensatory hyperkinesis in less than one-third of patients. The absence of LV wall thickening over time and the lack of remote myocardial strain changes with time suggest that these are not dominant effects in this cohort.…”

Transient global left ventricular dysfunction in a localized myocardial infarction related to occlusion of the distal left anterior descending artery

“…1,2 Homans et al 3 demonstrated that, in patients with multivessel disease, large wall motion abnormalities may increase the oxygen consumption by the remaining myocardium, and the dysfunction of this myocardium may be the result of relative hypoperfusion. Recent studies have reported that hypokinesis of remote myocardium may be associated with reduced coronary flow, reduced coronary flow reserve, increased remote loading on the noninfarcted region, or mechanical tethering of the noninfarcted region to the infracted myocardium.…”

“…Other suggested mechanisms include delayed nonculprit artery flow associated with extensive necrosis in shared microvasculature and vasoconstriction mediated by local neurohormonal reflexes. In addition, Yoshino et al 2 have shown that in anterior wall MI, decreased wall motion of the inferior wall is related to infarct-related narrowing or occlusion proximal to the origin of the first diagonal branch of the LAD. Nonetheless, our case exhibited severe global myocardial dysfunction in a patient with occlusion in the distal part of the LAD.…”

“…In some patients, however, myocardial function in the remote region and global left ventricular (LV) systolic function declines, 1, 2 and these patients usually have multivessel coronary disease or proximal left anterior descending artery (LAD) occlusion. 2,3 We report the case of a 53-year-old man who presented with severe but transient global LV dysfunction after an acute MI associated with distal LAD occlusion. We discuss the remote myocardial function in patients with acute MI and present a plausible mechanism of dysfunction of noninfarcted myocardium.…”