Gaudron, Peter and Kugler, Ingrid and Hu, Kai and Bauer, Wolfgang and Eilles, Christoph and Ertl, Georg (2001) Time course of cardiac structural, functional and electrical changes in asymptomatic patients after myocardial infarction: Their inter-relation and prognostic impact. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 38 (1). pp. 33-40. ISSN 0735-1097, 1558-3597
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OBJECTIVES We prospectively studied the relationship between left ventricular (LV) dilation, dysfunction, electrical instability and death in patients after a first myocardial infarction (MI) without symptoms of heart failure and ischemia. BACKGROUND Mechanisms linking LV dysfunction and sudden death in patients after MI remained controversial. METHODS Left ventricular volumes, hemodynamics, electrocardiogram and 24-h Holter recordings were sequentially obtained between two days and seven years after MI. Left ventricular catheterization and coronary angiography were performed, and revascularization was performed if appropriate. RESULTS Death occurred in 16 (12%) of the 134 patients included; it was of cardiac origin in 14 (88%) and sudden in origin in 12 (75%) patients. Of 37 (28%) patients with LV dilation, 12 died (32%); four patients (5.8%) died in the group without dilation. Left ventricular dilation was closely related to signs of electrical instability, as indicated by a significant correlation between end-diastolic LV volume index, Lown score (r = 0.98, p < 0.0001) and QTc prolongation (r = 0.998, p < 0.01), respectively. CONCLUSIONS Patients with progressive remodeling are at increased risk of sudden death in chronic MI. Cardiac electrical instability is closely related to progressive LV dilation. Parameters of electrical instability and remodeling are predictors of sudden death. The findings suggest that remodeling might serve as a link between dysfunction, electrical instability of the heart and sudden death after MI. CT Am Coil Cardiol 2001;38:33-40) (C) 2001 by the American College of Cardiology.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LEFT-VENTRICULAR DYSFUNCTION; HEART-RATE-VARIABILITY; ARRHYTHMIC EVENTS; SUDDEN-DEATH; FAILURE; HYPERTROPHY; MORTALITY; VARIABLES; SURVIVAL; DISEASE; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Nuklearmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 11 Jan 2022 14:18 |
| Last Modified: | 11 Jan 2022 14:18 |
| URI: | https://pred.uni-regensburg.de/id/eprint/41308 |
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