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The International Journal of Cardiovascular Imaging

, Volume 33, Issue 12, pp 2003–2012 | Cite as

Is cardiac magnetic resonance necessary for prediction of left ventricular remodeling in patients with reperfused ST-segment elevation myocardial infarction?

  • Eun Kyoung Kim
  • Young Bin Song
  • Sung-A Chang
  • Sung-Ji Park
  • Joo-Yong Hahn
  • Seung Hyuk Choi
  • Jin-Ho Choi
  • Hyeon-Cheol Gwon
  • Seung-Woo Park
  • Yeon Hyeon Choe
  • Joonghyun Ahn
  • Keumhee Carriere
  • Sang-Chol LeeEmail author
Original Paper

Abstract

As cardiac magnetic resonance imaging (CMR) has become widely used for evaluation of myocardial viability after acute myocardial infarction, the additional value of CMR parameters for prediction of left ventricle (LV) remodeling has been receiving interest. The aim of the study was to investigate the additional predictive value of CMR parameters for LV remodeling after successful reperfusion of ST-segment elevation myocardial infarction (STEMI) using multiple predictive models. LV remodeling was defined as ≥20% increase in end-diastolic volume at 6 month follow-up echocardiography. Using multiple stepwise regression analysis, conventional risk model was classified as following; model 1 (clinical factors), model 2 (model 1 + angiographic factors), model 3 (model 2 + echocardiographic factors) and CMR-added model; model 4 (model 3 + CMR factors). Among 262 enrolled patients, 25.1% showed LV remodeling. There were significant increments of c-statistics from the predictive model 1 to model 3 (AUC; 0.675 [0.60–0.75], 0.708 [0.64–0.78], 0.756 [0.69–0.82], respectively. all p < 0.05). However, model 4, which added the CMR variables, did not show any increase in predictive value compared with model 3 (AUC; 0.763 [0.70–0.83] versus 0.756 [0.69–0.82], p = 0.11). During the 28.2 months of median follow up, the incidence of hospitalization for heart failure was significantly higher in the patients with LV remodeling (6.1% vs. 0.5%, p = 0.02). CMR parameters did not provide incremental predictive value above the assessment by conventional echocardiography-based risk model in patients with STEMI.

Keywords

ST-segment elevation myocardial infarction Ventricular remodeling Cardiac magnetic resonance Echocardiography Coronary angiography 

Notes

Compliance with ethical standards

Conflict of interest

All authors have no conflict of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Eun Kyoung Kim
    • 1
  • Young Bin Song
    • 1
  • Sung-A Chang
    • 1
  • Sung-Ji Park
    • 1
  • Joo-Yong Hahn
    • 1
  • Seung Hyuk Choi
    • 1
  • Jin-Ho Choi
    • 1
  • Hyeon-Cheol Gwon
    • 1
  • Seung-Woo Park
    • 1
  • Yeon Hyeon Choe
    • 2
  • Joonghyun Ahn
    • 3
  • Keumhee Carriere
    • 3
    • 4
  • Sang-Chol Lee
    • 1
    Email author
  1. 1.Division of Cardiology, Heart Vascular Stroke Institute, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Radiology, Heart Vascular Stroke Institute, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  3. 3.Statistics and Data Center, Samsung Medical CenterSeoulRepublic of Korea
  4. 4.Department of Mathematical and Statistical SciencesUniversity of AlbertaEdmontonCanada

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