Prognostic value of left ventricular hypertrophy and geometry in patients with a first, uncomplicated myocardial infarction.
BACKGROUND
The prognostic impact of left ventricular (LV) geometry on cardiovascular risk for patients with a first, uncomplicated acute myocardial infarction (AMI), and echocardiographic ejection fraction > or =50% has not been well described.


RESULTS
Accordingly, 111 AMI consecutive patients (mean age 59.3+/-10 years) performed echocardiographic examination at predischarge. LV mass was calculated by means of Devereux's formula and subsequently indexed by body surface area. Fifty-three patients had LV hypertrophy and 58 patients had normal LV mass. The two groups were homogeneous for demographic, clinical and angiographic variables as well as for the incidence of residual ischemia on predischarge stress testing. During follow-up period there were 24 cardiac events (cardiac death, unstable angina and non-fatal reinfarction) in the 53 patients with LV hypertrophy and only four events in the remaining 58 patients without LV hypertrophy (RR=2.45; CI=1.76-3.41; P<0.0001). The patients with concentric LV hypertrophy showed a higher incidence of events (64%) than patients with eccentric LV hypertrophy (32%, P<0. 05) and patients with normal geometry and mass (6%, P<0.0001). Multivariate Cox regression model identified concentric geometry as the most powerful predictor of combined end-points (chi(2)=32.7, P<0. 0001).


CONCLUSIONS
An increased LV mass and concentric geometry resulted important independent markers of an adverse outcome in patients with a first, uncomplicated myocardial infarction and good LV function.
Carluccio
E
E
Department of Clinical and Experimental Medicine, Division of Cardiology, Policlinico Monteluce, University of Perugia, Via Brunamonti, 1, 06100 Perugia, Italy.
Tommasi
S
S
Bentivoglio
M
M
Buccolieri
M
M
Filippucci
L
L
Prosciutti
L
L
Corea
L
L
D000368:Aged; D000704:Analysis of Variance; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013318:Stroke Volume