Abstract 3291: Left Ventricular Twist Early After Myocardial Infarction Predicts Left Ventricular Remodeling
Background Left ventricular (LV) twist, the net difference between apical and basal rotation during systole, is emerging as a sensitive marker of systolic function. This study explored the effect of acute myocardial infarction (AMI) on LV twist, and determined the value of LV twist early after AMI in predicting LV remodeling at 6-month follow-up.
Methods. A total of 120 patients with a first ST-elevation AMI (59±10 years, 73% male) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, speckle tracking echocardiography was performed to assess LV twist, and infarct size was assessed by myocardial contrast echocardiography (MCE). At 6-month follow-up, LV volumes and LV ejection fraction were reassessed, in order to identity patients who developed LV remodeling (defined as ≥15% increase in LV end-systolic volume).
Results. As compared to control subjects, peak LV twist in AMI patients was significantly impaired (12.7±5.2° vs. 17.7±2.1°, p <0.001). At multivariate linear regression analysis, only LVEF (â =0.27, p=0.023) and infarct size (β =−0.44, p <0.001) determined by MCE, were independent factors associated with peak LV twist. At 6-month follow-up, 19 patients showed LV remodeling. At multivariate logistic regression analysis, only peak LV twist (OR=0.77; 95% CI 0.61–0.96; p=0.023) was independently related to the development of LV remodeling. At ROC curve analysis, peak LV twist ≤10.3° provided the highest sensitivity (90%) and specificity (84%) to predict LV remodeling (Figure⇓).
Conclusions. LV twist is significantly impaired early after AMI. The amount of impairment of LV twist predicts LV remodeling at 6-month follow-up.