Analysis of left ventricular changes after acute myocardial infarction using transthoracic real-time three-dimensional echocardiography.
BACKGROUND
Little information is available regarding the relationship between three-dimensional (3-D) echocardiographic parameters in acute stage of acute myocardial infarction (AMI) and subsequent left ventricular (LV) remodeling after AMI.


METHODS
Consecutive patients with AMI were analyzed for echocardiographic predictors of subsequent LV remodeling after AMI using two-dimensional (2-D) echocardiography and real-time 3-D echocardiography at baseline and month 3 of follow-up. LV adverse and favorable remodeling were defined as a >10% and <or=10% increase in 3-D derived LV end diastolic volume index (LVEDVI) at 3 months' follow-up compared with baseline, respectively.


RESULTS
19 AMI patients underwent real-time 3-D echocardiography at baseline and at 3 months after AMI. In patients with favorable remodeling (n = 12), baseline, LVEDVI, LV end-systolic volume index (LVESVI) and LV stroke volume index (LVSVI) were significantly increased compared with patients with adverse remodeling. At 3 months of follow-up, patients with favorable remodeling had significant 3-D LVEDVI, LVESVI, and systolic sphericity index reductions compared to patients with adverse remodeling in which these variables were increased. Baseline clinical and echocardiographic variables were analyzed for the identification of favorable LV remodeling. Of these, LVESVI was the most predictive variable with sensitivity, specificity, and positive and negative predictive values for a cutoff value of >42 mL/m(2) of 75%, 71%, 75%, and 71%, respectively.


CONCLUSIONS
LVESVI assessed by 3-D echocardiography was the most predictive parameter indicating favorable LV remodeling after AMI. LV shape on contraction changed from elliptical shape to more globular in the adverse remodeling process after AMI.
Yang
Ning-I
NI
Department of Medicine, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Keelung, Taiwan.
Hung
Ming-Jui
MJ
Cherng
Wen-Jin
WJ
Wang
Chao-Hung
CH
Cheng
Chi-Wen
CW
Kuo
Li-Tang
LT
D000368:Aged; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling