title: Impact of ventricular geometric pattern on cardiac remodeling after myocardial infarction.
abstract: BACKGROUND
  The relevance of left ventricular (LV) geometric pattern after myocardial infarction is not known.
  
  
  OBJECTIVE
  To analyze the presence of different LV geometric patterns and their impact as a predictor of remodeling in patients with myocardial infarction.
  
  
  METHODS
  Patients with anterior acute myocardial infarction (n = 80) were divided according to the geometric pattern: normal (normal left ventricular mass index [LVMI] and normal relative wall thickness [RWT]), concentric remodeling (normal LVMI and increased RWT), concentric hypertrophy (increased LVMI and RWT) and eccentric hypertrophy (increased LVMI and normal RWT). After six months, echocardiographic assessment was repeated.
  
  
  RESULTS
  Four patients died. Of the survivors, 41 showed remodeling (R +), whereas 39 did not (R-). Considering the geometric pattern, the cases were distributed as follows: 24 patients with normal pattern, 13 with concentric remodeling, 29 with concentric hypertrophy and 14 with eccentric hypertrophy. Patients who showed remodeling had larger infarction sizes analyzed by peak CPK (R + = 4,610 (1,688-7,970), R- = 1,442 (775-4247), p <0.001) and CK-MB (R + = 441 (246 - 666), R- = 183 (101-465), p <0.001), trend towards higher prevalence of concentric remodeling (R+ = 10, R- = 3, p = 0.08) and lower prevalence of eccentric hypertrophy (R + = 2 R- = 12, p = 0.006). In the multivariate regression analysis, infarction size was a predictor (OR = 1.01, p = 0.020) and eccentric hypertrophy was a protective factor (OR = 0.189, p = 0.046) of ventricular remodeling after coronary occlusion.
  
  
  CONCLUSIONS
  The LV geometric pattern of can have an impact on the remodeling process in patients with myocardial infarction.
authors: Faculdade de Medicina de Botucatu UNESP, Botucatu, SP, Brazil.
authors: Elaine
authors: E
authors: Farah
authors: Daniéliso R
authors: DR
authors: Fusco
authors: Paulo R R
authors: PR
authors: Okumoto
authors: Marcos F
authors: MF
authors: Minicucci
authors: Paula S
authors: PS
authors: Azevedo
authors: Beatriz B
authors: BB
authors: Matsubara
authors: Katashi
authors: K
authors: Okoshi
authors: Siméia G
authors: SG
authors: Zanati
authors: Sergio A R
authors: SA
authors: Paiva
authors: Leonardo A M
authors: LA
authors: Zornoff
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020257:Ventricular Remodeling / Q000502:physiology*