Prognostic implications of left ventricular dyssynchrony early after non-ST elevation myocardial infarction without congestive heart failure.
OBJECTIVE
To determine independent predictors of left ventricular (LV) dyssynchrony after non-ST elevation myocardial infarction (NSTEMI) and prognostic value of combining dyssynchrony parameters for long-term LV dysfunction.


RESULTS
Left ventricular dyssynchrony assessments were performed in 100 NSTEMI patients followed-up for 1 year using a composite dyssynchrony score. Early LV dyssynchrony was independently predicted by the presence of significant proximal left circumflex artery (LCx) stenosis and global systolic dysfunction. Left ventricular end-diastolic volume index decreased with time and was independently determined by a lower number of diseased vessels and the absence of early dyssynchrony. Left ventricular end-systolic volume index decreased with time and was independently determined by the absence of early dyssynchrony, lower number of diseased vessels, and revascularization. Left ventricular ejection fraction increased with time and was independently determined by the absence of early dyssynchrony, lower number of diseased vessels, and revascularization. The composite dyssynchrony score was an independent determinant of a persistently dilated LV and low LVEF at follow-up.


CONCLUSIONS
After NSTEMI, proximal LCx stenosis and impaired LV function independently predicted LV dyssynchrony. The composite dyssynchrony score had prognostic value and identified patients with persistently dilated and impaired LV on follow-up.
Ng
Arnold C T
AC
Department of Cardiology, Liverpool Hospital, University of New South Wales, Elizabeth Street, Liverpool, Sydney, NSW 2170, Australia.
Tran
Da T
da T
Allman
Christine
C
Vidaic
Jane
J
Leung
Dominic Y
DY
D000368:Aged; D006328:Cardiac Catheterization; D023921:Coronary Stenosis / Q000150:complications*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D009204:Myocardial Revascularization; D011379:Prognosis; D012307:Risk Factors; D020107:Troponin T / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000503:physiopathology; D020257:Ventricular Remodeling
D020107:Troponin T