Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling

Gaetano Nucifora, Nina Ajmone Marsan, Matteo Bertini, Victoria Delgado, Hans Marc J. Siebelink, Jacob M. Van Werkhoven, Arthur J. Scholte, Martin J. Schalij, Ernst E. Van Der Wall, Eduard R. Holman, Jeroen J. Bax

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background-Left ventricular (LV) torsion is emerging as a sensitive parameter of LV systolic myocardial performance. The aim of the present study was to explore the effects of acute myocardial infarction (AMI) on LV torsion and to determine the value of LV torsion early after AMI in predicting LV remodeling at 6-month follow-up. Methods and Results-A total of 120 patients with a first ST-segment elevation AMI (mean±SD age, 59±10 years; 73% male) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, speckletracking echocardiography was performed to assess LV torsion; infarct size was assessed by myocardial contrast echocardiography. At 6-month follow-up, LV volumes and LV ejection fraction were reassessed to identity patients with LV remodeling (defined as a ≥15% increase in LV end-systolic volume). Compared with control subjects, peak LV torsion in AMI patients was significantly impaired (1.54±0.64°/cm vs 2.07±0.27°/cm, P<0.001). By multivariate analysis, only LV ejection fraction (β=0.36, P<0.001) and infarct size (β=-0.47, P<0.001) were independently associated with peak LV torsion. At 6-month follow-up, 19 patients showed LV remodeling. By multivariate analysis, only peak LV torsion (odds ratio=0.77; 95% CI, 0.65- 0.92; P=0.003) and infarct size (odds ratio=1.04; 95% CI, 1.01-1.07; P=0.021) were independently related to LV remodeling. Peak LV torsion provided modest but significant incremental value over clinical, echocardiographic, and myocardial contrast echocardiography variables in predicting LV remodeling. By receiver-operating characteristics curve analysis, peak LV torsion ≤1.44°/cm provided the highest sensitivity (95%) and specificity (77%) to predict LV remodeling. Conclusions-LV torsion is significantly impaired early after AMI. The amount of impairment of LV torsion predicts LV remodeling at 6-month follow-up.

LanguageEnglish
Pages433-442
Number of pages10
JournalCirculation: Cardiovascular Imaging
Volume3
Issue number4
DOIs
Publication statusPublished - 1 Jul 2010

Keywords

  • Acute myocardial infarction
  • Infarct size
  • Left ventricular remodeling
  • Left ventricular torsion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Nucifora, G., Marsan, N. A., Bertini, M., Delgado, V., Siebelink, H. M. J., Van Werkhoven, J. M., ... Bax, J. J. (2010). Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling. Circulation: Cardiovascular Imaging, 3(4), 433-442. https://doi.org/10.1161/CIRCIMAGING.109.926196
Nucifora, Gaetano ; Marsan, Nina Ajmone ; Bertini, Matteo ; Delgado, Victoria ; Siebelink, Hans Marc J. ; Van Werkhoven, Jacob M. ; Scholte, Arthur J. ; Schalij, Martin J. ; Van Der Wall, Ernst E. ; Holman, Eduard R. ; Bax, Jeroen J. / Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling. In: Circulation: Cardiovascular Imaging. 2010 ; Vol. 3, No. 4. pp. 433-442.
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Nucifora, G, Marsan, NA, Bertini, M, Delgado, V, Siebelink, HMJ, Van Werkhoven, JM, Scholte, AJ, Schalij, MJ, Van Der Wall, EE, Holman, ER & Bax, JJ 2010, 'Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling', Circulation: Cardiovascular Imaging, vol. 3, no. 4, pp. 433-442. https://doi.org/10.1161/CIRCIMAGING.109.926196

Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling. / Nucifora, Gaetano; Marsan, Nina Ajmone; Bertini, Matteo; Delgado, Victoria; Siebelink, Hans Marc J.; Van Werkhoven, Jacob M.; Scholte, Arthur J.; Schalij, Martin J.; Van Der Wall, Ernst E.; Holman, Eduard R.; Bax, Jeroen J.

In: Circulation: Cardiovascular Imaging, Vol. 3, No. 4, 01.07.2010, p. 433-442.

Research output: Contribution to journalArticle

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T1 - Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling

AU - Nucifora, Gaetano

AU - Marsan, Nina Ajmone

AU - Bertini, Matteo

AU - Delgado, Victoria

AU - Siebelink, Hans Marc J.

AU - Van Werkhoven, Jacob M.

AU - Scholte, Arthur J.

AU - Schalij, Martin J.

AU - Van Der Wall, Ernst E.

AU - Holman, Eduard R.

AU - Bax, Jeroen J.

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N2 - Background-Left ventricular (LV) torsion is emerging as a sensitive parameter of LV systolic myocardial performance. The aim of the present study was to explore the effects of acute myocardial infarction (AMI) on LV torsion and to determine the value of LV torsion early after AMI in predicting LV remodeling at 6-month follow-up. Methods and Results-A total of 120 patients with a first ST-segment elevation AMI (mean±SD age, 59±10 years; 73% male) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, speckletracking echocardiography was performed to assess LV torsion; infarct size was assessed by myocardial contrast echocardiography. At 6-month follow-up, LV volumes and LV ejection fraction were reassessed to identity patients with LV remodeling (defined as a ≥15% increase in LV end-systolic volume). Compared with control subjects, peak LV torsion in AMI patients was significantly impaired (1.54±0.64°/cm vs 2.07±0.27°/cm, P<0.001). By multivariate analysis, only LV ejection fraction (β=0.36, P<0.001) and infarct size (β=-0.47, P<0.001) were independently associated with peak LV torsion. At 6-month follow-up, 19 patients showed LV remodeling. By multivariate analysis, only peak LV torsion (odds ratio=0.77; 95% CI, 0.65- 0.92; P=0.003) and infarct size (odds ratio=1.04; 95% CI, 1.01-1.07; P=0.021) were independently related to LV remodeling. Peak LV torsion provided modest but significant incremental value over clinical, echocardiographic, and myocardial contrast echocardiography variables in predicting LV remodeling. By receiver-operating characteristics curve analysis, peak LV torsion ≤1.44°/cm provided the highest sensitivity (95%) and specificity (77%) to predict LV remodeling. Conclusions-LV torsion is significantly impaired early after AMI. The amount of impairment of LV torsion predicts LV remodeling at 6-month follow-up.

AB - Background-Left ventricular (LV) torsion is emerging as a sensitive parameter of LV systolic myocardial performance. The aim of the present study was to explore the effects of acute myocardial infarction (AMI) on LV torsion and to determine the value of LV torsion early after AMI in predicting LV remodeling at 6-month follow-up. Methods and Results-A total of 120 patients with a first ST-segment elevation AMI (mean±SD age, 59±10 years; 73% male) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, speckletracking echocardiography was performed to assess LV torsion; infarct size was assessed by myocardial contrast echocardiography. At 6-month follow-up, LV volumes and LV ejection fraction were reassessed to identity patients with LV remodeling (defined as a ≥15% increase in LV end-systolic volume). Compared with control subjects, peak LV torsion in AMI patients was significantly impaired (1.54±0.64°/cm vs 2.07±0.27°/cm, P<0.001). By multivariate analysis, only LV ejection fraction (β=0.36, P<0.001) and infarct size (β=-0.47, P<0.001) were independently associated with peak LV torsion. At 6-month follow-up, 19 patients showed LV remodeling. By multivariate analysis, only peak LV torsion (odds ratio=0.77; 95% CI, 0.65- 0.92; P=0.003) and infarct size (odds ratio=1.04; 95% CI, 1.01-1.07; P=0.021) were independently related to LV remodeling. Peak LV torsion provided modest but significant incremental value over clinical, echocardiographic, and myocardial contrast echocardiography variables in predicting LV remodeling. By receiver-operating characteristics curve analysis, peak LV torsion ≤1.44°/cm provided the highest sensitivity (95%) and specificity (77%) to predict LV remodeling. Conclusions-LV torsion is significantly impaired early after AMI. The amount of impairment of LV torsion predicts LV remodeling at 6-month follow-up.

KW - Acute myocardial infarction

KW - Infarct size

KW - Left ventricular remodeling

KW - Left ventricular torsion

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