title: Function of remote non-infarcted myocardium after STEMI: analysis with cardiovascular magnetic resonance.
abstract: To evaluate remote myocardial function after ST-elevation myocardial infarction (STEMI) and the impact of infarct size (IS) using cardiovascular magnetic resonance (CMR). 161 patients and 15 controls underwent CMR at 1st week and 6th month after STEMI. Using the 17-segments model, segments were categorized into infarcted, adjacent and remote myocardium. Relative systolic wall thickening (SWT, %) was assessed using the centerline method. IS (% of left ventricular mass) was determined in late enhancement imaging. Overall, in remote myocardium, SWT was comparable (83 ± 32) to controls (77 ± 25, P = .5) and did not increase significantly (P = .2) at the 6th month (88 ± 35, P = .3 vs. control). When IS was categorized into tertiles (<13.6%, (n = 49), 13.7-28.2%, (n = 60), >28.2%, (n = 52)), SWT in the remote area at the 1st week was not different from controls, regardless of infarct size (p between .2 and .8 for all tertiles). At 6 months, SWT was larger compared to controls only in small infarctions (98 ± 34 vs. 77 ± 25, P = .03). In medium and large infarctions there was no difference in SWT of the remote area compared to controls (87 ± 33 and 79 ± 34, P = .3 and P = .09) and there was no significant increase at 6 months (P between .2 and .9). In remote myocardium there was no difference in contractility compared to controls after STEMI. After 6 month a slight hypercontractility can only be observed in small infarctions. In medium and large infarctions no difference of SWT in remote myocardium compared to controls can be observed.
authors.affiliation: Cardiology Department, Hospital Clinico Universitario, INCLIVA, Universidad de Valencia, Blasco Ibanez 17, 46010 Valencia, Spain.
authors.forename: Oliver
authors.initials: O
authors.lastname: Husser
authors.forename: Fabian
authors.initials: F
authors.lastname: Chaustre
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: Julio
authors.initials: J
authors.lastname: Nunez
authors.forename: Jose V
authors.initials: JV
authors.lastname: Monmeneu
authors.forename: Maria P
authors.initials: MP
authors.lastname: Lopez-Lereu
authors.forename: Clara
authors.initials: C
authors.lastname: Bonanad
authors.forename: Cristina
authors.initials: C
authors.lastname: Gomez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Oltra
authors.forename: Angel
authors.initials: A
authors.lastname: Llacer
authors.forename: Günter A J
authors.initials: GA
authors.lastname: Riegger
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodi
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left