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. 2013 Jul;101(1):43-51.
doi: 10.5935/abc.20130112. Epub 2013 May 31.

3D Echo pilot study of geometric left ventricular changes after acute myocardial infarction

[Article in English, Portuguese]
Marcelo Luiz Campos Vieira  1 , Wercules Antonio Oliveira, Adriana Cordovil, Ana Clara Tude Rodrigues, Cláudia Gianini Mônaco, Tânia Afonso, Edgar Bezerra Lira Filho, Marco Perin, Cláudio Henrique Fischer, Samira Saady Morhy
Affiliations

3D Echo pilot study of geometric left ventricular changes after acute myocardial infarction

[Article in English, Portuguese]
Marcelo Luiz Campos Vieira et al. Arq Bras Cardiol. 2013 Jul.

Abstract

Background: Left ventricular remodeling (LVR) after AMI characterizes a factor of poor prognosis. There is little information in the literature on the LVR analyzed with three-dimensional echocardiography (3D ECHO).

Objective: To analyze, with 3D ECHO, the geometric and volumetric modifications of the left ventricle (VE) six months after AMI in patients subjected to percutaneous primary treatment.

Methods: Prospective study with 3D ECHO of 21 subjects (16 men, 56 ± 12 years-old), affected by AMI with ST segment elevation. The morphological and functional analysis (LV) with 3D ECHO (volumes, LVEF, 3D sphericity index) was carried out up to seven days and six months after the AMI. The LVR was considered for increase > 15% of the end diastolic volume of the LV (LVEDV) six months after the AMI, compared to the LVEDV up to seven days from the event.

Results: Eight (38%) patients have presented LVR. Echocardiographic measurements (n = 21 patients): I- up to seven days after the AMI: 1- LVEDV: 92.3 ± 22.3 mL; 2- LVEF: 0.51 ± 0.01; 3- sphericity index: 0.38 ± 0.05; II- after six months: 1- LVEDV: 107.3 ± 26.8 mL; 2- LVEF: 0.59 ± 0.01; 3- sphericity index: 0.31 ± 0.05. Correlation coefficient (r) between the sphericity index up to seven days after the AMI and the LVEDV at six months (n = 8) after the AMI: r: 0.74, p = 0.0007; (r) between the sphericity index six months after the AMI and the LVEDV at six months after the AMI: r: 0.85, p < 0.0001.

Conclusion: In this series, LVR has been observed in 38% of the patients six months after the AMI. The three-dimensional sphericity index has been associated to the occurrence of LVR.

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Conflict of interest statement

Potential Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Chart 1
Chart 1
Histogram for the demonstration of the end diastolic volumes of the left ventricle measured with three-dimensional echocardiography (LVEDV) up to seven days and six months (6M) after the myocardial infarction of the total population of the study (n = 21); 3D LVEDV: 92.3 ± 22.3 mL; 3D LVEDV 6M: 107.3 ± 26.8 mL.
Chart 2
Chart 2
Demonstration in Box-Plot of the three-dimensional sphericity index (3D) of the left ventricle up to seven days and six months (6M) after the myocardial infarction of the total population of the study (n = 21); 3D sphericity index: 0.38 ± 0.05; 3D sphericity index: 0.31 ± 0.05.
Figure 1
Figure 1
Measurement of the ventricular volumes and of the ejection fraction of the left ventricle measured with the use of three-dimensional trans thoracic echocardiography; EDV (end diastolic volume): 102.3 mL; ESV (end systolic volume): 32.2 mL; EF (ejection fraction): 68.5%; SV (ejected systolic volume): 70.1 mL.
Figure 2
Figure 2
Demonstration of the measurement of the three-dimensional sphericity index (3D SI): 0.26, in accordance with: 3D SI: LVEDV 4/3 π (D/2)3, for LVEDV: 102.3 mL (Picture 1); (D): 9.1 cm; Arrows: demonstration of the longitudinal diameter of the ventricle in apical four chamber projection.
See this image and copyright information in PMC

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