title: Remote Zone Extracellular Volume and Left Ventricular Remodeling in Survivors of ST-Elevation Myocardial Infarction.
abstract: The natural history and pathophysiological significance of tissue remodeling in the myocardial remote zone after acute ST-elevation myocardial infarction (STEMI) is incompletely understood. Extracellular volume (ECV) in myocardial regions of interest can now be measured with cardiac magnetic resonance imaging. Patients who sustained an acute STEMI were enrolled in a cohort study (BHF MR-MI [British Heart Foundation Magnetic Resonance Imaging in Acute ST-Segment Elevation Myocardial Infarction study]). Cardiac magnetic resonance was performed at 1.5 Tesla at 2 days and 6 months post STEMI. T1 modified Look-Locker inversion recovery mapping was performed before and 15 minutes after contrast (0.15 mmol/kg gadoterate meglumine) in 140 patients at 2 days post STEMI (mean age: 59 years, 76% male) and in 131 patients at 6 months post STEMI. Remote zone ECV was lower than infarct zone ECV (25.6±2.8% versus 51.4±8.9%; P<0.001). In multivariable regression, left ventricular ejection fraction was inversely associated with remote zone ECV (P<0.001), and diabetes mellitus was positively associated with remote zone ECV (P=0.010). No ST-segment resolution (P=0.034) and extent of ischemic area at risk (P<0.001) were multivariable associates of the change in remote zone ECV at 6 months (ΔECV). ΔECV was a multivariable associate of the change in left ventricular end-diastolic volume at 6 months (regression coefficient [95% confidence interval]: 1.43 (0.10-2.76); P=0.036). ΔECV is implicated in the pathophysiology of left ventricular remodeling post STEMI, but because the effect size is small, ΔECV has limited use as a clinical biomarker of remodeling.
  
  
  
  URL: https://www.clinicaltrials.gov. Unique identifier: NCT02072850.
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Carberry
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: David
authors.initials: D
authors.lastname: Carrick
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Caroline
authors.initials: C
authors.lastname: Haig
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Samuli M
authors.initials: SM
authors.lastname: Rauhalammi
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Nadeem
authors.initials: N
authors.lastname: Ahmed
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Ify
authors.initials: I
authors.lastname: Mordi
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Margaret
authors.initials: M
authors.lastname: McEntegart
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Mark C
authors.initials: MC
authors.lastname: Petrie
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Hany
authors.initials: H
authors.lastname: Eteiba
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Stuart
authors.initials: S
authors.lastname: Hood
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Stuart
authors.initials: S
authors.lastname: Watkins
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Mitchell
authors.initials: M
authors.lastname: Lindsay
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Andrew
authors.initials: A
authors.lastname: Davie
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mahrous
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Ian
authors.initials: I
authors.lastname: Ford
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Paul
authors.initials: P
authors.lastname: Welsh
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Radjenovic
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.).
authors.forename: Keith G
authors.initials: KG
authors.lastname: Oldroyd
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre (J.C., D.C., S.M.R., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Glasgow, United Kingdom; and Golden Jubilee National Hospital, Dunbartonshire, United Kingdom (D.C., S.W., C.B.). colin.berry@glasgow.ac.uk.
authors.forename: Colin
authors.initials: C
authors.lastname: Berry
mesh_terms: D000368:Aged; D005110:Extracellular Space / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011897:Random Allocation; D000072657:ST Elevation Myocardial Infarction / Q000473:pathology / Q000503:physiopathology; D013223:Statistics as Topic; D013318:Stroke Volume; D020257:Ventricular Remodeling
keywords: edema; extracellular matrix; magnetic resonance imaging; myocardial infarction; myocardium