Redefining Adverse and Reverse Left Ventricular Remodeling by Cardiovascular Magnetic Resonance Following ST-Segment–Elevation Myocardial Infarction and Their Implications on Long-Term Prognosis

Bulluck, Heerajnarain; Carberry, Jaclyn; Carrick, David; McEntegart, Margaret; Petrie, Mark C.; Eteiba, Hany; Hood, Stuart; Watkins, Stuart; Lindsay, Mitchell; Mahrous, Ahmed; Ford, Ian; Oldroyd, Keith G.; Berry, Colin

doi:10.1161/circimaging.119.009937

Cited by 31 publications

(30 citation statements)

References 29 publications

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“…2,4,5,24,25 A significant number of STEMI survivors, however, continue to experience HF, independent of cardiac remodeling and reduced LVEF, displaying a phenotype of preserved EF (HFpEF) characterized by reduced cardiac reserve and impaired cardiorespiratory fitness. 2,4,5,[24][25][26][27] In the pooled data analysis of 3 VCU-ART clinical trials, 8 (50%) of the patients had a reduced LVEF at follow-up (LVEF ,40%), whereas 4 (25%) had LVEF 40%-50% and 4 (25%) had HFpEF (LVEF .50%). 23 The inflammatory response during STEMI may modulate the response of the cardiomyocytes and other cells during the initial ischemic injury.…”

Section: Discussionmentioning

confidence: 99%

Effect of IL-1 Blockade With Anakinra on Heart Failure Outcomes in Patients With Anterior Versus Nonanterior ST Elevation Myocardial Infarction

Buono

Damonte

Chiabrando

et al. 2022

Journal of Cardiovascular Pharmacology

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:Patients with ST elevation myocardial infarction (STEMI) are at risk of future heart failure (HF), particularly those with anterior STEMI. Interleukin-1 (IL-1) is a key mediator of the inflammatory response, and its blockade has emerged as a potential therapeutic strategy to prevent HF events. The aim of this analysis was to explore the effects of anakinra, an IL-1 receptor antagonist, on HF outcomes based on anterior versus nonanterior location STEMI and to explore whether this effect is mediated through the amelioration of left ventricular systolic function and cardiac remodeling. We pooled data from 3 early phase randomized clinical trials. The primary end point was a composite of all-cause death and new-onset HF at 1-year follow-up. The left anterior descending coronary artery as culprit vessel was used to identify anterior STEMI. We included 139 patients, 47 (34%) with anterior STEMI and 92 (66%) with nonanterior STEMI. Anakinra significantly reduced the combined end point of death or new-onset HF in patients with anterior STEMI [4 (13%) vs. 7 (42%), log-rank P value = 0.049] and in patients with nonanterior STEMI [3 (6%) vs. 9 (24%), log-rank P value = 0.014]. We found no significant differences comparing anakinra versus placebo in interval changes in left ventricular ejection fraction and volumes in anterior and nonanterior STEMI. In conclusion, anakinra is associated with a reduction of HF events in patients with STEMI, irrespective of anterior or nonanterior location, or of changes in left ventricular ejection fraction or cardiac remodeling.

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Section: Discussionmentioning

confidence: 99%

Effect of IL-1 Blockade With Anakinra on Heart Failure Outcomes in Patients With Anterior Versus Nonanterior ST Elevation Myocardial Infarction

Buono

Damonte

Chiabrando

et al. 2022

Journal of Cardiovascular Pharmacology

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“…These cut‐offs are in agreement with previously published studies. LV reverse remodelling was defined as an improvement in either LVEDVI or LVESVI of >12–15% in multiple other studies 18–20 . An improvement in LA end‐systolic volume >15% has been used as a definition of LA reverse remodelling as well 21 .…”

Section: Methodsmentioning

confidence: 99%

Global longitudinal strain and outcome after endoscopic mitral valve repair

Kotrč

Bartúnek²,

Benes

et al. 2022

ESC Heart Failure

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Aims Identification of heart failure (HF) patients with secondary mitral regurgitation (SMR) that benefit from mitral valve (MV) repair remains challenging. We have focused on the role of left ventricular global longitudinal strain (LV-GLS) and reservoir left atrial longitudinal strain (LASr) for the prediction of long-term survival and reverse remodelling in patients with SMR undergoing endoscopic MV repair. Methods and resultsThe study population consisted of 110 patients (age 67 ± 11 years, 66% men) with symptomatic SMR undergoing isolated MV repair using a minimally invasive surgical approach. Speckle tracking-derived LV-GLS and LASr were assessed in apical views using vendor-independent software. Over a median of 7.7 years (IQRs 2.9-11.2), 64 patients (58%) died. Significant reverse LV (↓ LVESVI >10 mL/m 2 ), LA (↓ LAVI >10 mL/m 2 ) remodelling or both were observed in 43 (39%), 37 (34%) and 19 (17%) patients, respectively. LV-GLS (HR 0.68, 95% CI 0.58-0.79, P < 0.001) and LASr (HR 0.93, 95% CI 0.88-0.97, P < 0.01) but not LV ejection fraction (LVEF) and LA volume index (LAVi) emerged as independent predictors of all-cause mortality in Cox regression analysis. LV-GLS was the only independent predictor of LV reverse remodelling (OR 1.24, 95% CI 1.05-1.43, P < 0.001) whereas LAVi and LASr were both independent predictors of LA reverse remodelling (both P < 0.05). In patients with atrial fibrillation at baseline, only LASr was an independent predictor (P < 0.05) of LA reverse remodelling. Conclusions In patients with SMR undergoing endoscopic MV repair, LV-GLS and LASr are independently associated with long-term survival and reverse remodelling and may be helpful in selecting SMR patients who may benefit from this procedure.

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“…Stroke volume was calculated as LVEDV minus LVESV, and LV ejection fraction (LVEF) was calculated as follows: LVEF = [(LVEDV -LVESV)/ LVEDV] × 100. The definition of AR was based on an increase of LVEDV by ≥ 12% at 6 months post-MI 12,15 .…”

Section: Cmr Imagingmentioning

confidence: 99%

Admission Monocyte/HDL Ratio Predicts Adverse Cardiac Remodeling After St-Elevation Myocardial Infarction

Eyyüpkoca¹,

Yıldırım²,

Sivri³

et al. 2022

RIC

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Background: Inflammation plays a critical role in cardiac remodeling after myocardial infarction (MI). Monocyte to high-density lipoprotein-cholesterol (HDL-C) ratio (MHR) has emerged as a potential indicator of inflammation. Objectives: The study aimed to investigate the prognostic role of MHR at the time of hospital admission in late cardiac remodeling and subsequent 1-year mortality in an academic training and research hospital. Methods: This prospective multicenter study included 231 patients with acute ST-elevation MI. Left ventricular (LV) functions and volumes were assessed by cardiac magnetic resonance (CMR)imaging at 2 weeks and 6 months post-MI. The definition of adverse cardiac remodeling (AR) was based on the increase of LV end-diastolic volume by ≥ 12% at 6 months post-MI. All patients were followed for survival for 1 year after the second CMR imaging measurements. Results: At 6 months post-MI, 20 patients (23.8%) exhibited AR. The median MHR was higher in the AR group compared to the group without AR (2.2 vs. 1.5, p < 0.001). A positive correlation was found between MHR and infarct size in the groups with and without AR. High MHR was an independent predictor of AR (OR: 3.21, p = 0.002). The cut-off value of MHR in predicting AR was found to be >1.6 with 92.7% sensitivity and 70.1% specificity (AUC ± SE: 0.839 ± 0.03, p < 0.001). Mortality risk was 5.62-fold higher in the group with MHR of >1.6 (HR: 5.62, p < 0.001). Conclusions: These results indicate that admission MHR is a useful tool to predict patients with AR who are at risk of progression to heart failure and mortality after MI. (REV INVEST CLIN. [AHEAD OF PRINT]

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Redefining Adverse and Reverse Left Ventricular Remodeling by Cardiovascular Magnetic Resonance Following ST-Segment–Elevation Myocardial Infarction and Their Implications on Long-Term Prognosis

Cited by 31 publications

References 29 publications

Effect of IL-1 Blockade With Anakinra on Heart Failure Outcomes in Patients With Anterior Versus Nonanterior ST Elevation Myocardial Infarction

Effect of IL-1 Blockade With Anakinra on Heart Failure Outcomes in Patients With Anterior Versus Nonanterior ST Elevation Myocardial Infarction

Global longitudinal strain and outcome after endoscopic mitral valve repair

Admission Monocyte/HDL Ratio Predicts Adverse Cardiac Remodeling After St-Elevation Myocardial Infarction

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