Predictors of recovery of left ventricular systolic dysfunction after acute myocardial infarction: from the korean acute myocardial infarction registry and korean myocardial infarction registry

We investigated the predictors of the recovery of depressed left ventricular ejection fraction (LVEF) in patients with moderate or severe left ventricular (LV) systolic dysfunction after acute myocardial infarction (MI). We analyzed 1307 patients, who had moderately or severely depressed LVEF (<4...

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Published inKorean circulation journal Vol. 43; no. 8; pp. 527 - 533
Main Authors Oh, Pyung Chun, Choi, In Suck, Ahn, Taehoon, Moon, Jeonggeun, Park, Yeonjeong, Seo, Jong Goo, Suh, Soon Yong, Ahn, Youngkeun, Jeong, Myung Ho
Format Journal Article
LanguageEnglish
Published Korea (South) The Korean Society of Cardiology 01.08.2013
대한심장학회
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Summary:We investigated the predictors of the recovery of depressed left ventricular ejection fraction (LVEF) in patients with moderate or severe left ventricular (LV) systolic dysfunction after acute myocardial infarction (MI). We analyzed 1307 patients, who had moderately or severely depressed LVEF (<45%) on echocardiography soon after acute MI and who underwent a follow-up echocardiography, among 27369 patients from the Korea Working Group on the Myocardial Infarction Registry. Patients were categorized into two groups according to recovery of LVEF: group I with consistently depressed LVEF (<45%) at the follow-up echocardiography and group II with a recovery of LVEF (≥45%). Recovery of LV systolic dysfunction was observed in 51% of the subjects (group II, n=663; ΔLVEF, 16.2±9.3%), whereas there was no recovery in the remaining subjects (group I, n=644; ΔLVEF, 0.6±7.1%). In the multivariate analysis, independent predictors of recovery of depressed LVEF were as follows {odds ratio (OR) [95% confidence interval (CI)]}: moderate systolic dysfunction {LVEF ≥30% and <45%; 1.73 (1.12-2.67)}, Killip class I-II {1.52 (1.06-2.18)}, no need for diuretics {1.59 (1.19-2.12)}, non-ST-segment elevation MI {1.55 (1.12-2.16)}, lower peak troponin I level {<24 ng/mL, median value; 1.55 (1.16-2.07)}, single-vessel disease {1.53 (1.13-2.06)}, and non-left anterior descending (LAD) culprit lesion {1.50 (1.09-2.06)}. In addition, the use of statin was independently associated with a recovery of LV systolic dysfunction {OR (95% CI), 1.46 (1.07-2.00)}. Future contractile recovery of LV systolic dysfunction following acute MI was significantly related with less severe heart failure at the time of presentation, a smaller extent of myonecrosis, or non-LAD culprit lesions rather than LAD lesions.
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These authors contributed equally to this work.
G704-000708.2013.43.8.008
ISSN:1738-5520
1738-5555
DOI:10.4070/kcj.2013.43.8.527