Dyslipidemia, low left ventricular ejection fraction and high wall motion score index are predictors of progressive left ventricular dilatation after acute myocardial infarction

血脂异常、左心室射血分数低和室壁运动评分指数高是急性心肌梗死后进行性左心室扩张的预测因素。

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Abstract

BACKGROUND AND OBJECTIVES: Left ventricular (LV) remodeling is a heterogeneous process, involving both infarcted and non-infarcted zones, which affects wall thickness and chamber size, shape and function. SUBJECTS AND METHODS: A total of 758 consecutive patients (62.8±12.0 years, 539 males) with acute myocardial infarction (AMI), who were examined by echocardiography at admission and after 6 months. An increase in LV end-diastolic volume index >10% was defined as a progressive LV dilation. They were divided into two groups according to the extent of progressive LV dilatation during 6 months. Group I with progressive LV dilatation (n=154, 61.4±11.0 years, 110 males) vs. group II without LV dilatation (n=604, 64.1±12.0 years, 429 males). RESULTS: The age and gender were no significant differences between two groups. The levels of glucose, creatinine, maximal creatine kinase (CK), CK-MB, troponin T and I were significantly increased in group I than in group II (p<0.05). Low ejection fraction (EF) and high wall motion score index (WMSI) were more common in group I than in group II (p<0.05). The presence of dyslipidemia {odds ratio (OR); 1.559, confidence interval (CI); 1.035-2.347, p=0.03}, low EF less than 45% (OR; 3.328, CI 2.099-5.276, p<0.01) and high WMSI above 1.5 (OR; 3.328, CI 2.099-5.276, p<0.01) were sig-nificant independent predictors of progressive LV dilatation by multivariate analysis. CONCLUSION: Dyslipidemia, decreased systolic function and high WMSI were independent predictors of LV remodeling process in patients with AMI.

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