A mismatch index based on the difference between measured left ventricular ejection fraction and that estimated by infarct size at three months following reperfused acute myocardial infarction

TY - JOUR

T1 - A mismatch index based on the difference between measured left ventricular ejection fraction and that estimated by infarct size at three months following reperfused acute myocardial infarction

AU - Carlsen, Esben A

AU - Bang, Lia E

AU - Lønborg, Jacob

AU - Ahtarovski, Kiril A

AU - Køber, Lars

AU - Kelbæk, Henning

AU - Vejlstrup, Niels

AU - Jørgensen, Erik

AU - Helqvist, Steffen

AU - Saunamäki, Kari

AU - Clemmensen, Peter

AU - Holmvang, Lene

AU - Wagner, Galen S

AU - Engstrøm, Thomas

N1 - Copyright © 2014 Elsevier Inc. All rights reserved.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - BACKGROUND AND AIM: The reduction of left ventricular ejection fraction (LVEF) following ST-segment elevation myocardial infarction (STEMI) is a result of infarcted myocardium and may involve dysfunctional but viable myocardium. An index that may quantitatively determine whether LVEF is reduced beyond the expected value when considering only infarct size (IS) has previously been presented based on cardiac magnetic resonance (CMR). The purpose of this study was to introduce the index based on the electrocardiogram (ECG) and compare indices based on ECG and CMR.METHOD AND RESULTS: In 55 patients ECG and CMR were obtained 3 months after STEMI treated with primary percutaneous coronary intervention. Significant, however moderate inverse relationships were found between measured LVEF and IS. Based on IS and LVEF an IS estimated LVEF was derived and an MI-LVEF mismatch index was calculated as the difference between measured LVEF and IS estimated LVEF. In 41 (74.5%) of the patients there was agreement between the ECG and CMR indices in regards to categorizing indices as >10 or ≤ 10 and generally no significant difference was detected, mean difference of 1.26 percentage points (p = 0.53).CONCLUSION: The study found an overall good agreement between MI-LVEF mismatch indices based on ECG and CMR. The MI-LVEF mismatch index may serve as a tool to identify patients with potentially reversible dysfunctional but viable myocardium, but future studies including both ECG and CMR are needed.

AB - BACKGROUND AND AIM: The reduction of left ventricular ejection fraction (LVEF) following ST-segment elevation myocardial infarction (STEMI) is a result of infarcted myocardium and may involve dysfunctional but viable myocardium. An index that may quantitatively determine whether LVEF is reduced beyond the expected value when considering only infarct size (IS) has previously been presented based on cardiac magnetic resonance (CMR). The purpose of this study was to introduce the index based on the electrocardiogram (ECG) and compare indices based on ECG and CMR.METHOD AND RESULTS: In 55 patients ECG and CMR were obtained 3 months after STEMI treated with primary percutaneous coronary intervention. Significant, however moderate inverse relationships were found between measured LVEF and IS. Based on IS and LVEF an IS estimated LVEF was derived and an MI-LVEF mismatch index was calculated as the difference between measured LVEF and IS estimated LVEF. In 41 (74.5%) of the patients there was agreement between the ECG and CMR indices in regards to categorizing indices as >10 or ≤ 10 and generally no significant difference was detected, mean difference of 1.26 percentage points (p = 0.53).CONCLUSION: The study found an overall good agreement between MI-LVEF mismatch indices based on ECG and CMR. The MI-LVEF mismatch index may serve as a tool to identify patients with potentially reversible dysfunctional but viable myocardium, but future studies including both ECG and CMR are needed.

KW - Electrocardiography

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Percutaneous Coronary Intervention

KW - Retrospective Studies

KW - Time Factors

KW - Ventricular Dysfunction, Left

U2 - 10.1016/j.jelectrocard.2013.10.009

DO - 10.1016/j.jelectrocard.2013.10.009

M3 - Journal article

C2 - 24373864

SN - 0022-0736

VL - 47

SP - 191

EP - 196

JO - Journal of Electrocardiology

JF - Journal of Electrocardiology

IS - 2

ER -