title: Relationship between location and size of myocardial infarction and their reciprocal influences on post-infarction left ventricular remodelling.
abstract: OBJECTIVE
  To assess the intricate relationship between myocardial infarction (MI) location and size and their reciprocal influences on post-infarction left ventricular (LV) remodelling.
  
  
  RESULTS
  A cohort of 260 reperfused ST-segment elevation MI patients was prospectively studied with cardiovascular magnetic resonance at 1 week (baseline) and 4 months (follow-up). Area at risk (AAR) and MI size were quantified by T2-weighted and late-gadolinium enhancement imaging, respectively. Adverse LV remodelling was defined as an increase in LV end-systolic volume ≥15% at follow-up. One hundred and twenty-seven (49%) patients had anterior MI and 133 (51%) patients had non-anterior MI. Although the degree of myocardial salvage was similar between groups (P = 0.74), anterior MI patients had larger AAR and MI size than non-anterior MI patients yielding worse regional and global LV function at baseline and follow-up. At univariable analysis, anterior MI was associated with increased risk of adverse LV remodelling (P = 0.017) and lower LV ejection fraction (EF) at follow-up (P = 0.001), but not when accounted for baseline MI size. Accordingly, at multivariable analysis, baseline MI size but not its location was an independent predictor of adverse LV remodelling (odds ratio = 1.061, P < 0.001) and EF at follow-up (β-coefficient = -0.255, P < 0.001).
  
  
  CONCLUSIONS
  Anterior MI patients experience more pronounced post-infarction LV remodelling and dysfunction than non-anterior MI patients due to a greater magnitude of irreversible ischaemic LV damage without any independent contribution of MI location.
authors.affiliation: MRI Department, Fondazione G.Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Masci
authors.forename: Javier
authors.initials: J
authors.lastname: Ganame
authors.forename: Marco
authors.initials: M
authors.lastname: Francone
authors.forename: Walter
authors.initials: W
authors.lastname: Desmet
authors.forename: Valentina
authors.initials: V
authors.lastname: Lorenzoni
authors.forename: Ilaria
authors.initials: I
authors.lastname: Iacucci
authors.forename: Andrea
authors.initials: A
authors.lastname: Barison
authors.forename: Iacopo
authors.initials: I
authors.lastname: Carbone
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
authors.forename: Luciano
authors.initials: L
authors.lastname: Agati
authors.forename: Stefan
authors.initials: S
authors.lastname: Janssens
authors.forename: Jan
authors.initials: J
authors.lastname: Bogaert
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D015425:Myocardial Reperfusion / Q000379:methods; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000473:pathology; D020257:Ventricular Remodeling / Q000502:physiology*