Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling

Ahmet Demirkiran; Rob J. van der Geest; Luuk H. G. A. Hopman; Lourens F. H. J. Robbers; M. Louis Handoko; Robin Nijveldt; John P. Greenwood; Sven Plein; Pankaj Garg

doi:10.1016/j.ijcard.2022.08.040

Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling

Ahmet Demirkiran, Rob J. van der Geest, Luuk H. G. A. Hopman, Lourens F. H. J. Robbers, M. Louis Handoko, Robin Nijveldt, John P. Greenwood, Sven Plein, Pankaj Garg

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Myocardial infarction leads to complex changes in left ventricular (LV) hemodynamics. It remains unknown how four-dimensional acute changes in LV-cavity blood flow kinetic energy affects LV-remodeling.

Methods and results: In total, 69 revascularised ST-segment elevation myocardial infarction (STEMI) patients were enrolled. All patients underwent cardiovascular magnetic resonance (CMR) examination within 2 days of the index event and at 3-month. CMR examination included cine, late gadolinium enhancement, and whole-heart four-dimensional flow acquisitions. LV volume-function, infarct size (indexed to body surface area), microvascular obstruction, mitral inflow, and blood flow KEi (kinetic energy indexed to end-diastolic volume) characteristics were obtained. Adverse LV-remodeling was defined and categorized according to increase in LV end-diastolic volume of at least 10%, 15%, and 20%. Twenty-four patients (35%) developed at least 10%, 17 patients (25%) at least 15%, 11 patients (16%) at least 20% LV-remodeling. Demographics and clinical history were comparable between patients with/without LV-remodeling. In univariable regression-analysis, A-wave KEi was associated with at least 10%, 15%, and 20% LV-remodeling (p = 0.03, p = 0.02, p = 0.02, respectively), whereas infarct size only with at least 10% LV-remodeling (p = 0.02). In multivariable regression-analysis, A-wave KEi was identified as an independent marker for at least 10%, 15%, and 20% LV-remodeling (p = 0.09, p < 0.01, p < 0.01, respectively), yet infarct size only for at least 10% LV-remodeling (p = 0.03).

Conclusion: In patients with STEMI, LV hemodynamic assessment by LV blood flow kinetic energetics demonstrates a significant inverse association with adverse LV-remodeling. Late-diastolic LV blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling.

Original language	English
Pages (from-to)	105-114
Number of pages	10
Journal	International Journal of Cardiology
Volume	367
Early online date	23 Aug 2022
DOIs	https://doi.org/10.1016/j.ijcard.2022.08.040
Publication status	Published - 15 Nov 2022

Keywords

Kinetic energy
Left ventricular remodeling
ST-segment elevation myocardial infarction

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https://linkinghub.elsevier.com/retrieve/pii/S0167527322012505Licence: CC BY

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Demirkiran, A., van der Geest, R. J., Hopman, L. H. G. A., Robbers, L. F. H. J., Handoko, M. L., Nijveldt, R., Greenwood, J. P., Plein, S., & Garg, P. (2022). Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling. International Journal of Cardiology, 367, 105-114. https://doi.org/10.1016/j.ijcard.2022.08.040

Demirkiran, Ahmet ; van der Geest, Rob J. ; Hopman, Luuk H. G. A. ; Robbers, Lourens F. H. J. ; Handoko, M. Louis ; Nijveldt, Robin ; Greenwood, John P. ; Plein, Sven ; Garg, Pankaj. / Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling. In: International Journal of Cardiology. 2022 ; Vol. 367. pp. 105-114.

@article{639f202019224ca8b877650a0408aafb,

title = "Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling",

abstract = "Background: Myocardial infarction leads to complex changes in left ventricular (LV) hemodynamics. It remains unknown how four-dimensional acute changes in LV-cavity blood flow kinetic energy affects LV-remodeling.Methods and results: In total, 69 revascularised ST-segment elevation myocardial infarction (STEMI) patients were enrolled. All patients underwent cardiovascular magnetic resonance (CMR) examination within 2 days of the index event and at 3-month. CMR examination included cine, late gadolinium enhancement, and whole-heart four-dimensional flow acquisitions. LV volume-function, infarct size (indexed to body surface area), microvascular obstruction, mitral inflow, and blood flow KEi (kinetic energy indexed to end-diastolic volume) characteristics were obtained. Adverse LV-remodeling was defined and categorized according to increase in LV end-diastolic volume of at least 10%, 15%, and 20%. Twenty-four patients (35%) developed at least 10%, 17 patients (25%) at least 15%, 11 patients (16%) at least 20% LV-remodeling. Demographics and clinical history were comparable between patients with/without LV-remodeling. In univariable regression-analysis, A-wave KEi was associated with at least 10%, 15%, and 20% LV-remodeling (p = 0.03, p = 0.02, p = 0.02, respectively), whereas infarct size only with at least 10% LV-remodeling (p = 0.02). In multivariable regression-analysis, A-wave KEi was identified as an independent marker for at least 10%, 15%, and 20% LV-remodeling (p = 0.09, p < 0.01, p < 0.01, respectively), yet infarct size only for at least 10% LV-remodeling (p = 0.03).Conclusion: In patients with STEMI, LV hemodynamic assessment by LV blood flow kinetic energetics demonstrates a significant inverse association with adverse LV-remodeling. Late-diastolic LV blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling.",

keywords = "Kinetic energy, Left ventricular remodeling, ST-segment elevation myocardial infarction",

author = "Ahmet Demirkiran and {van der Geest}, {Rob J.} and Hopman, {Luuk H. G. A.} and Robbers, {Lourens F. H. J.} and Handoko, {M. Louis} and Robin Nijveldt and Greenwood, {John P.} and Sven Plein and Pankaj Garg",

note = "Funding information: This work was supported by the British Heart Foundation [FS/10/62/28409 to S.P.]. This work was partly funded by Wellcome Trust grants (220703/Z/20/Z). Rights retention statement: For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.",

year = "2022",

month = nov,

day = "15",

doi = "10.1016/j.ijcard.2022.08.040",

language = "English",

volume = "367",

pages = "105--114",

journal = "International Journal of Cardiology",

issn = "1874-1754",

publisher = "Elsevier",

}

Demirkiran, A, van der Geest, RJ, Hopman, LHGA, Robbers, LFHJ, Handoko, ML, Nijveldt, R, Greenwood, JP, Plein, S & Garg, P 2022, 'Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling', International Journal of Cardiology, vol. 367, pp. 105-114. https://doi.org/10.1016/j.ijcard.2022.08.040

Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling. / Demirkiran, Ahmet; van der Geest, Rob J.; Hopman, Luuk H. G. A.; Robbers, Lourens F. H. J.; Handoko, M. Louis; Nijveldt, Robin; Greenwood, John P.; Plein, Sven; Garg, Pankaj.

In: International Journal of Cardiology, Vol. 367, 15.11.2022, p. 105-114.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling

AU - Demirkiran, Ahmet

AU - van der Geest, Rob J.

AU - Hopman, Luuk H. G. A.

AU - Robbers, Lourens F. H. J.

AU - Handoko, M. Louis

AU - Nijveldt, Robin

AU - Greenwood, John P.

AU - Plein, Sven

AU - Garg, Pankaj

N1 - Funding information: This work was supported by the British Heart Foundation [FS/10/62/28409 to S.P.]. This work was partly funded by Wellcome Trust grants (220703/Z/20/Z). Rights retention statement: For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.

PY - 2022/11/15

Y1 - 2022/11/15

N2 - Background: Myocardial infarction leads to complex changes in left ventricular (LV) hemodynamics. It remains unknown how four-dimensional acute changes in LV-cavity blood flow kinetic energy affects LV-remodeling.Methods and results: In total, 69 revascularised ST-segment elevation myocardial infarction (STEMI) patients were enrolled. All patients underwent cardiovascular magnetic resonance (CMR) examination within 2 days of the index event and at 3-month. CMR examination included cine, late gadolinium enhancement, and whole-heart four-dimensional flow acquisitions. LV volume-function, infarct size (indexed to body surface area), microvascular obstruction, mitral inflow, and blood flow KEi (kinetic energy indexed to end-diastolic volume) characteristics were obtained. Adverse LV-remodeling was defined and categorized according to increase in LV end-diastolic volume of at least 10%, 15%, and 20%. Twenty-four patients (35%) developed at least 10%, 17 patients (25%) at least 15%, 11 patients (16%) at least 20% LV-remodeling. Demographics and clinical history were comparable between patients with/without LV-remodeling. In univariable regression-analysis, A-wave KEi was associated with at least 10%, 15%, and 20% LV-remodeling (p = 0.03, p = 0.02, p = 0.02, respectively), whereas infarct size only with at least 10% LV-remodeling (p = 0.02). In multivariable regression-analysis, A-wave KEi was identified as an independent marker for at least 10%, 15%, and 20% LV-remodeling (p = 0.09, p < 0.01, p < 0.01, respectively), yet infarct size only for at least 10% LV-remodeling (p = 0.03).Conclusion: In patients with STEMI, LV hemodynamic assessment by LV blood flow kinetic energetics demonstrates a significant inverse association with adverse LV-remodeling. Late-diastolic LV blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling.

AB - Background: Myocardial infarction leads to complex changes in left ventricular (LV) hemodynamics. It remains unknown how four-dimensional acute changes in LV-cavity blood flow kinetic energy affects LV-remodeling.Methods and results: In total, 69 revascularised ST-segment elevation myocardial infarction (STEMI) patients were enrolled. All patients underwent cardiovascular magnetic resonance (CMR) examination within 2 days of the index event and at 3-month. CMR examination included cine, late gadolinium enhancement, and whole-heart four-dimensional flow acquisitions. LV volume-function, infarct size (indexed to body surface area), microvascular obstruction, mitral inflow, and blood flow KEi (kinetic energy indexed to end-diastolic volume) characteristics were obtained. Adverse LV-remodeling was defined and categorized according to increase in LV end-diastolic volume of at least 10%, 15%, and 20%. Twenty-four patients (35%) developed at least 10%, 17 patients (25%) at least 15%, 11 patients (16%) at least 20% LV-remodeling. Demographics and clinical history were comparable between patients with/without LV-remodeling. In univariable regression-analysis, A-wave KEi was associated with at least 10%, 15%, and 20% LV-remodeling (p = 0.03, p = 0.02, p = 0.02, respectively), whereas infarct size only with at least 10% LV-remodeling (p = 0.02). In multivariable regression-analysis, A-wave KEi was identified as an independent marker for at least 10%, 15%, and 20% LV-remodeling (p = 0.09, p < 0.01, p < 0.01, respectively), yet infarct size only for at least 10% LV-remodeling (p = 0.03).Conclusion: In patients with STEMI, LV hemodynamic assessment by LV blood flow kinetic energetics demonstrates a significant inverse association with adverse LV-remodeling. Late-diastolic LV blood flow kinetic energetics early after acute MI was independently associated with adverse LV-remodeling.

KW - Kinetic energy

KW - Left ventricular remodeling

KW - ST-segment elevation myocardial infarction

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U2 - 10.1016/j.ijcard.2022.08.040

DO - 10.1016/j.ijcard.2022.08.040

M3 - Article

VL - 367

SP - 105

EP - 114

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 1874-1754

ER -

Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling

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Novel Non-invasive Haemodynamic Methods in Heart Failure with Preserved Ejection Fraction

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Association of left ventricular flow energetics with remodeling after myocardial infarction: New hemodynamic insights for left ventricular remodeling

Abstract

Keywords

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Novel Non-invasive Haemodynamic Methods in Heart Failure with Preserved Ejection Fraction

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