Ventricular-arterial uncoupling as early marker of unfavorable left ventricular remodeling in patients with myocardial infarctionDownload in PDF
To evaluate the relationship of unfavorable left ventricular (LV) remodeling with the left ventricular-arterial coupling (VAC) in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI).
Material and methods
We used two-dimensional echo cardiography to assess arterial elastance (Ea) and end-systolic LV elastance (Ees) on admission and at 6 months in 112 patients with MI and PCI (68% male, age 61.1±9.5 years). VAC was calculated as Ea/Ees ratio. Cardiac remodeling was defined as an increase of LV end-diastolic and/or end-systolic volume by more than 20% compared with baseline.
At baseline, all patients had left ventricular ejection fraction (LV EF) >40% while VAC was in optimal range (0.5-1.2). At 6 months, VAC ≥1.2 was found in 67 (60%) patients, and unfavorable LV remodeling was present in 81 (72%) patients. Achieved VAC ≥1.2 was associated with adverse cardiac remodeling (odds ratio 6.16; 95% confidence interval 2.47-15.37; p<0.0005). A significant correlation was found between LV remodeling and VAC after 6 months (r=0,41; p <0,05).
Increased VAC indicating LV-arterial uncoupling may be an early marker of unfavorable LV remodeling.
.Myocardial infarction, adverse left ventricular remodeling, ventricular-arterial coupling.