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Eur Heart J Cardiovasc Imaging. 2016 Feb;17(2):169-76. doi: 10.1093/ehjci/jev129. Epub 2015 Jun 7.

Prognostic value of left ventricular global function index in patients after ST-segment elevation myocardial infarction.

Author information

1
University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, Innsbruck A-6020, Austria.
2
Department of Cardiac Surgery, Medical University of Innsbruck, Anichstraße 35, Innsbruck A-6020, Austria.
3
Department for Medical Statistics, Medical University of Innsbruck, Schöpfstraße 41/1, Innsbruck A-6020, Austria.
4
Department of Radiology, Medical University of Innsbruck, Anichstraße 35, Innsbruck A-6020, Austria.
5
University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, Innsbruck A-6020, Austria bernhard.metzler@uki.at.

Abstract

AIMS:

The left ventricular global function index (LVGFI) is a novel indicator of left ventricular performance. Its prognostic value in patients after ST-segment elevation myocardial infarction (STEMI) is unknown. We sought to evaluate the prognostic significance of LVGFI measured by cardiovascular magnetic resonance (CMR) imaging after STEMI.

METHODS AND RESULTS:

Two hundred eligible STEMI patients (56 ± 11 years, 16% female) revascularized by primary percutaneous coronary intervention were followed-up for 3.1 [2-4.1] years for major adverse cardiac events (MACE). MACE was defined as a composite of death, non-fatal myocardial re-infarction, and new congestive heart failure. All patients underwent CMR imaging within 2 [2-4] days after STEMI. Late enhancement and cine images were acquired to assess myocardial injury as well as myocardial function, including LVGFI. Patients suffering a MACE event (n = 20, 10%) had a significantly lower LVGFI (P = 0.001). In Kaplan-Meier analysis, a decreased LVGFI was associated with a reduced MACE-free survival (P < 0.001). Multivariate Cox regression analysis revealed a decreased LVGFI as a predictor for MACE [hazard ratio = 4.79, 95% confidence interval (CI) 1.46-15.67, P = 0.010] after adjusting for microvascular obstruction, left ventricular mass, and multivessel disease. In receiver operating characteristic analysis, LVGFI was a strong predictor for MACE (area under the curve = 0.73, CI 0.61-0.85). However, c-statistics revealed that LVGFI does not provide incremental prognostic information over left ventricular ejection fraction (LVEF) (P = 0.38).

CONCLUSION:

LVGFI assessed by CMR is a strong predictor of MACE within 3 years after first STEMI. A superior predictive value as compared with LVEF was not found in this study.

KEYWORDS:

Left ventricular global function index; Magnetic resonance imaging; Myocardial infarction; Prognosis

PMID:
26056134
PMCID:
PMC4882876
DOI:
10.1093/ehjci/jev129
[Indexed for MEDLINE]
Free PMC Article

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