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• W2044366914 abstract "Background: The determinants of the early and late stages of the ventricular remodeling process after infarction are not well defined. Hypothesis: The study was undertaken to evaluate the factors that condition the time course of left ventricular dilation during the first 6 months after infarction. Methods: The study group consisted of 74 patients with a first intermediate-large (≥ 4 Q waves) acute myocardial infarction. Contrast left ventricular and coronary angiograms were performed at 7 ± 1 and 175 ± 25 days after infarction. Left ventricular volumes, regional function and infarction artery status were quantified. Percutaneous transluminal coronary angioplasty (PTCA) was performed in the early angiogram in 31 patients. Results: in the early angiogram, 13 patients showed ventricular remodeling (end-diastolic volume > 90 ml/m2). A larger extent of dysfunction was the only predictor (p < 0.002) of early remodeling. At 6 months, a smaller, early end-diastolic volume (p < 0.0001) and a poorer regional function recovery (p < 0.05) were independently related to late diastolic enlargement, and a poorer regional function recovery (p < 0.0001) and a smaller, early end-systolic volume (p < 0.009) were independently related to late systolic enlargement. One patient with compared with 20 patients without early remodeling (p < 0.04) presented with late remodeling (increment of the end-diastolic volume > 20% at 6 months). in patients with early remodeling, the end-diastolic volume did not change significantly (101 ± 13 vs. 94 ± 22 ml/m2, NS) at 6 months; despite this, they maintained larger diastolic volumes than patients with late remodeling (81 ± 12 ml/m2, p < 0.04) at 6 months. Infarction artery status did not influence the evolution of ventricular volumes and regional function. Conclusions: (1) A large infarct size is the main determinant of postinfarction remodeling. (2) Such infarct size-dependent ventricular dilation occurs early and does not tend to increase in late stage; in contrast, some cases of intermediate-large size infarcts without early remodeling exhibit late remodeling associated with a poor late recovery of regional function. (3) Recovery of regional function (indicating myocardial viability) rather than infarction artery status plays a role in the late ventricular remodeling process." @default.
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• W2044366914 date "1999-09-01" @default.
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• W2044366914 title "Predictors of early and late ventricular remodeling after acute myocardial infarction" @default.
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• W2044366914 doi "https://doi.org/10.1002/clc.4960220908" @default.
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