Left ventricular remodelling after acute myocardial infarction: Impact of clinical, echocardiographic parameters and polymorphism of angiotensinogen gene

Abstract

Introduction: The development of left ventricular remodelling after acute myocardial infarction is a predictor of heart failure and mortality. The purpose of the present study was to assess whether the polymorphism of angiotensinogen (AGT) gene with threonine (T) instead of methionine (M) at amino acid 235 in exon 2 (M235T) had effects on cardiac remodelling after acute myocardial infarction. Methods: One hundred and forty-one patients (mean age 56.4±11.1 years) with a first acute myocardial infarction were enrolled. Within 24-72 hours of the onset of the symptoms and at a four month period two-dimensional echocardiography was performed. Remodelling was defined as a 20% increase from the baseline in left ventricular end-diastolic volume. The genotypes of the study group were compared with the reference group (n=1010) genotypes. AGT M235T polymorphism was determined using polymerase chain reaction amplification. Results: At follow-up, 49 patients (34.7%) were classified as having left ventricular remodelling. Anterior localization of the infarct (p=0.008), leucocyte count at admission (p=0.040), global left ventricular longitudinal strain (p=0.021) and MM genotype of AGT (p=0.024) were independent predictors of ventricular remodelling after myocardial infarction. Conclusions: Anterior wall infarction, increased leucocyte count, decreased longitudinal strain of left ventricular and polymorphism of AGT M235T may predict remodelling after myocardial infarction.

Wall motion changes in myocardial infarction in relation to the time elapsed from symptoms until revascularization

“…We decided not to apply cut-off values for characterizing the remodeling process; rather, we investigated the diameter changes due to the remodeling between the early and late managed groups. Inflammatory and genetic factors may also play role in remodeling ( 12 ).…”

Prognostic Value of Speckle Tracking Echocardiography in Patients with ST‐Elevation Myocardial Infarction Treated with Late Percutaneous Intervention

“…Earlier studies by Balcells et al 23 and Swinburn et al 24 showed a correlation between regional wall-motion abnormalities and the results of perfusion contrast echocardiography assessing the viability of infarcted segments. 10,11,17,26 LV systolic characteristics post-MI can be evaluated by STE, including the myocardium peak systolic magnitude or velocity of different directions (peak systolic strain or strain rate of longitudinal, circumferential, and radial directions), LV mechanical dyssynchrony (SD of time to peak systolic strain), and postsystolic motion (postsystolic strain); however, which parameter can more powerfully predict LVr or clinical prognosis is unknown, particularly in AMI patients treated with late PCI. These techniques are angle independent and can differentiate between active contraction and passive displacement; thus, they are more accurate than Doppler tissue imaging for evaluating the regional function of the LV, 25 and several studies have reported that STE can be used to predict LVr or clinical prognosis.…”

“…These techniques are angle independent and can differentiate between active contraction and passive displacement; thus, they are more accurate than Doppler tissue imaging for evaluating the regional function of the LV, 25 and several studies have reported that STE can be used to predict LVr or clinical prognosis. 10,11,17,26 LV systolic characteristics post-MI can be evaluated by STE, including the myocardium peak systolic magnitude or velocity of different directions (peak systolic strain or strain rate of longitudinal, circumferential, and radial directions), LV mechanical dyssynchrony (SD of time to peak systolic strain), and postsystolic motion (postsystolic strain); however, which parameter can more powerfully predict LVr or clinical prognosis is unknown, particularly in AMI patients treated with late PCI. Our study showed that only GLS, RS are independent predictors of LVr during 6-9 months follow-up post-AMI, but the dyssynchrony and postsystolic motion of the LV cannot independently predict LVr, and GLS appears to be more powerful for predicting LVr.…”

Post-Infarction Remodelling and Diffusion Capacity of the Lungs: Is There Any Connection?

“…В целом показатели размеров и объемов полостей сердца отражают интенсивность и скорость процесса ремоделирования миокарда: чем интенсивнее процессы, тем сферичнее полости сердца [9]. При умеренно выраженной систолической дисфункции ЛЖ отмечаются признаки его умеренной дилатации (увеличение КСО и КДО ЛЖ), при этом в течение некоторого времени сердечный индекс сохраняется в пределах нормальных значений [10]. Кроме того, заслуживают внимания имеющиеся данные о развитии ремоделирования сердца даже, несмотря на выбор оптимальной лечебной тактики у больных ИМ с подъемом сегмента ST -выполнения первичного ЧКВ по экстренным показаниям или тромболитической терапии [11].…”