Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12968-017-0343-9
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dc.titleDefining left ventricular remodeling following acute ST-segment elevation myocardial infarction using cardiovascular magnetic resonance
dc.contributor.authorBulluck, H
dc.contributor.authorGo, Y.Y
dc.contributor.authorCrimi, G
dc.contributor.authorLudman, A.J
dc.contributor.authorRosmini, S
dc.contributor.authorAbdel-Gadir, A
dc.contributor.authorBhuva, A.N
dc.contributor.authorTreibel, T.A
dc.contributor.authorFontana, M
dc.contributor.authorPica, S
dc.contributor.authorRaineri, C
dc.contributor.authorSirker, A
dc.contributor.authorHerrey, A.S
dc.contributor.authorManisty, C
dc.contributor.authorGroves, A
dc.contributor.authorMoon, J.C
dc.contributor.authorHausenloy, D.J
dc.date.accessioned2020-11-17T06:34:30Z
dc.date.available2020-11-17T06:34:30Z
dc.date.issued2017
dc.identifier.citationBulluck, H, Go, Y.Y, Crimi, G, Ludman, A.J, Rosmini, S, Abdel-Gadir, A, Bhuva, A.N, Treibel, T.A, Fontana, M, Pica, S, Raineri, C, Sirker, A, Herrey, A.S, Manisty, C, Groves, A, Moon, J.C, Hausenloy, D.J (2017). Defining left ventricular remodeling following acute ST-segment elevation myocardial infarction using cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance 19 (1) : 26. ScholarBank@NUS Repository. https://doi.org/10.1186/s12968-017-0343-9
dc.identifier.issn1097-6647
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/183540
dc.description.abstractBackground: The assessment of post-myocardial infarction (MI) left ventricular (LV) remodeling by cardiovascular magnetic resonance (CMR) currently uses criteria defined by echocardiography. Our aim was to provide CMR criteria for assessing LV remodeling following acute MI. Methods: Firstly, 40 reperfused ST-segment elevation myocardial infarction (ST%?EMI) patients with paired acute (4 ± 2 days) and follow-up (5 ± 2 months) CMR scans were analyzed by 2 independent reviewers and the minimal detectable changes (MDCs) for percentage change in LV end-diastolic volume (%ΔLVEDV), LV end-systolic volume (%ΔLVESV), and LV ejection fraction (%ΔLVEF) between the acute and follow-up scans were determined. Secondly, in 146 reperfused STEMI patients, receiver operator characteristic curve analyses for predicting LVEF <50% at follow-up (as a surrogate for clinical poor clinical outcome) were undertaken to obtain cut-off values for %ΔLVEDV and %ΔLVESV. Results: The MDCs for %ΔLVEDV, %ΔLVESV, and %ΔLVEF were similar at 12%, 12%, 13%, respectively. The cut-off values for predicting LVEF < 50% at follow-up were 11% for %ΔLVEDV on receiver operating characteristic curve analysis (area under the curve (AUC) 0.75, 95% CI 0.6 to 0.83, sensitivity 72% specificity 70%), and 5% for %ΔLVESV (AUC 0.83, 95% CI 0.77 to 0.90, sensitivity and specificity 78%). Using cut-off MDC values (higher than the clinically important cut-off values) of 12% for both %ΔLVEDV and %ΔLVESV, 4 main patterns of LV remodeling were identified in our cohort: reverse LV remodeling (LVEF predominantly improved); no LV remodeling (LVEF predominantly unchanged); adverse LV remodeling with compensation (LVEF predominantly improved); and adverse LV remodeling (LVEF unchanged or worsened). Conclusions: The MDCs for %ΔLVEDV and %ΔLVESV between the acute and follow-up CMR scans of 12% each may be used to define adverse or reverse LV remodeling post-STEMI. The MDC for %ΔLVEF of 13%, relative to baseline, provides the minimal effect size required for investigating treatments aimed at improving LVEF following acute STEMI. © 2017 The Author(s).
dc.publisherBMC
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceUnpaywall 20201031
dc.subjectadult
dc.subjectArticle
dc.subjectcardiovascular magnetic resonance
dc.subjectclinical article
dc.subjectfemale
dc.subjectfollow up
dc.subjectheart left ventricle ejection fraction
dc.subjectheart left ventricle enddiastolic volume
dc.subjectheart left ventricle endsystolic volume
dc.subjectheart left ventricle mass
dc.subjectheart muscle reperfusion
dc.subjectheart ventricle remodeling
dc.subjecthuman
dc.subjectmale
dc.subjectobserver variation
dc.subjectsensitivity and specificity
dc.subjectST segment elevation myocardial infarction
dc.subjectaged
dc.subjectarea under the curve
dc.subjectcine magnetic resonance imaging
dc.subjectdiagnostic imaging
dc.subjectheart left ventricle function
dc.subjectheart stroke volume
dc.subjectheart ventricle remodeling
dc.subjectmiddle aged
dc.subjectpathophysiology
dc.subjectpercutaneous coronary intervention
dc.subjectpredictive value
dc.subjectreceiver operating characteristic
dc.subjectreproducibility
dc.subjectST segment elevation myocardial infarction
dc.subjecttime factor
dc.subjecttreatment outcome
dc.subjectAged
dc.subjectArea Under Curve
dc.subjectFemale
dc.subjectHumans
dc.subjectMagnetic Resonance Imaging, Cine
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectObserver Variation
dc.subjectPercutaneous Coronary Intervention
dc.subjectPredictive Value of Tests
dc.subjectReproducibility of Results
dc.subjectROC Curve
dc.subjectST Elevation Myocardial Infarction
dc.subjectStroke Volume
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectVentricular Function, Left
dc.subjectVentricular Remodeling
dc.typeArticle
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1186/s12968-017-0343-9
dc.description.sourcetitleJournal of Cardiovascular Magnetic Resonance
dc.description.volume19
dc.description.issue1
dc.description.page26
dc.published.statePublished
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