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Regional myocardial shape alterations in patients with anterior myocardial infarction

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Abstract

Objective: To assess the impact of regional left ventricular curvature in patients with an acute anterior myocardial infarction on ventricular volume.Methods: Left ventricular curvature was calculated at 100 points from apical four chamber echocardiograms of 68 patients with an acute anterior wall infarction. Curvature at any point of the contour was defined as the reciprocal of the radius of the circle that intersects that point tangentially and was independent of volume and geometric assumptions. Curvature, volume and shape of the patient group was compared with these measurements in 20 normal volunteers.Results: Diastolic curvature differed at the borderzone of the infarct and the apical area. In the basal septal area (point 9–18) mean curvature was lower in the patient group (0.1±2.7 versus 2.1±0.7; p<0.0001) as compared to the normal individuals. In the mid-septal area (point 22 to 27), mean curvature was more concave (− 0.1±2.6) in the patient group corresponding to in the normal population (− 0.4±1.3) p<0.005. In the apex point 52 and 53 diverged with a curvature of 9.9±1.9 in patients versus 9.4±2.9 p<0.005 in normal individuals. Systolic curvature diverged at the basal septum (point 1–4) with a mean curvature of 1.4±1.1 in patients compared to 3.5±2.5 in normal individuals p<0.01. Curvature differed also in the mid-septal region (point 9–29) with a curvature of − 1.7±1.2 in patients versus 0.4±0.9 (p<0.01) in normal individuals and in the apical septum (point 48–52) with a curvature of 16.6±5.2 in patients and 13.9±2.6 (p<0.0001) in healthy individuals. Separation of patients with the greatest curvature alteration to those with minor curvature change revealed, that baseline curvature analysis can discriminate patients at risk for left ventricular remodelling.Conclusion: Regional curvature analysis correctly identifies the geometric changes induced by myocardial infarction. Apical systolic curvature can distinguish those patients that are at risk for left ventricular remodelling from those who are not at risk.

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References

  1. Hutchins GM, Bulkley BH. Infarct expansion versus extension: two different complications of acute myocardial infarction. Am J Cardiol 1978; 41: 1127–32.

    PubMed  Google Scholar 

  2. Kitamura S, Kay JH, Krohn BG, Magidson O, Dunne EF. Geometric and functional abnormalities of the left ventricle with a chronic localized noncontractile area. J Cardiol 1973; 31: 701–7.

    Google Scholar 

  3. Jeremy RW, Hackworthy RA, Bautovich G, Hutton BF, Harris PJ. Infarct artery perfusion and changes in left ventricular volume in the month after acute myocardial infarction. J Am Coll Cardiol 1987; 9: 989–95.

    PubMed  Google Scholar 

  4. Jeremy RW, Allman KC, Bautovich G, Harris PJ. Patterns of left ventricular dilatation during six months after myocardial infarction. J Am Coll Cardiol 1989; 13: 304–10.

    PubMed  Google Scholar 

  5. Pfeffer JM, Pfeffer MA, Fletcher PJ, Braunwald E. Progressive ventricular remodeling in rat with myocardial infarction. Am J Physiol 1991; 260: H1406–14.

    PubMed  Google Scholar 

  6. Eaton LW, Weiss JH, Bulkley BH, Garrison JB, Weisfeldt ML. Regional cardiac dilatation after myocardial infarction: recognition by 2-dimensional echocardiography. N Engl J Med 1979; 300: 57–62.

    PubMed  Google Scholar 

  7. Laarse A van de, Vermeer F, Hermens WTC, Willems GM, de Neef K, Simoons ML, Serruys PW, Res J, Verheugt FWA, Krauss XH, Bär F, de Zwaan C, Lubsen J. Effects of early intracoronary streptokinase on infarct size estimated from cumulative enzyme release and on enzyme release rate: a randomised trial of 533 patients with acute myocardial infarction. Am Heart J 1986; 112: 672–81.

    PubMed  Google Scholar 

  8. Lamas GA, Vaughan DE, Parisi AF, Pfeffer MA. Effect of left ventricular shape and captopril therapy on exercise capacity after anterior wall acute myocardial infarction. Am J Cardiol 1989; 63: 1167–73.

    PubMed  Google Scholar 

  9. Kass DA, Traill TA, Keating M, Altieri PI, Maughan WA. Abnormalities of dynamic ventricular shape change in patients with aortic and mitral valvular regurgitation: Assessment by Fourier shape analysis and global geometric indexes. Circ Res 1988; 62: 127–38.

    PubMed  Google Scholar 

  10. Segar DS, Brown SE, Sawada SG, Ryan T, Feigenbaum H. Dobutamine stress echocardiography: Correlation with coronary lesion severity as determined by quantitative angiography. J Am Coll Cardiol 1992; 19: 1197–202.

    PubMed  Google Scholar 

  11. Fishbein MC, Maclean D, Maroko PR. The histologic evolution of myocardial infarction. Chest 1978; 73: 843–9.

    PubMed  Google Scholar 

  12. Eaton LW, Weis JL, Bulkley BH, Garrison JB, Weisfeldt ML. Regional cardiac dilatation after acute myocardial infarction: recognition by two-dimensional echocardiography. N Engl J Med 1979; 300: 57–62.

    PubMed  Google Scholar 

  13. Meizlisch JL, Berger HJ, Plankey M, Errico D, Levy W, Zaret BL. Functional left ventricular aneurysm formation after acute anterior transmural myocardial infarction: Incidence, natural history and prognostic implications. N Engl J Med 1984; 311: 1001–6.

    PubMed  Google Scholar 

  14. Theroux GM, Ross J Jr, Franklin D, Covell JW, Bloor CM, Sarayama S. Regional myocardial function and dimensions early and late after myocardial infarction in the unanesthetized dog. Circ Res 1977; 40: 158–65.

    PubMed  Google Scholar 

  15. Burton AC. The importance of the shape and size of the heart. Am Heart J 1957; 54: 801–40.

    PubMed  Google Scholar 

  16. Woods RH. A few applications of a physical theorem to membrane in the human body in a state of tension. J Anat Physiol 1892; 26: 362–70.

    Google Scholar 

  17. Mitchell GF, Lamas GA, Vaughan DE, Pfeffer MA. Left ventricular remodeling in the year after first anterior infarction: a quantitative analysis of contractile segment length and ventricular shape. J Am Coll Cardiol 1992; 19: 1136–44.

    PubMed  Google Scholar 

  18. Gibson DG, Brown DJ. Continuous assessment of left ventricular shape in man. Br Heart J 1975; 37: 904–10.

    PubMed  Google Scholar 

  19. Mancini GBJ, De Boe SF, Anselmo E, Simon SB, Le Free MT, Vogel RA. Quantitative regional curvature analysis: an application of shape determination for the assessment of segmental left ventricular function in man. Am Heart J 1987; 113: 326–34.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Bronovo Hospital, The Hague, The Netherlands

    Johan J. Kerkkamp

  2. Department of Cardiology, University Hospital Leiden, Building 1, C5-P33, Rijnsburgerweg 10, 2333 AA, Leiden, The Netherlands

    Leo H. B. Baur, Johan J. Schipperheyn, Ernst E. van der Wall, Johan H. C. Reiber, Arjan D. van Dijk, Cees Brobbel, Johan J. Kerkkamp, Paul J. Voogd & A. V. G. Bruschke

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  1. Leo H. B. Baur
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  2. Johan J. Schipperheyn
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  3. Ernst E. van der Wall
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  4. Johan H. C. Reiber
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  5. Arjan D. van Dijk
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  6. Cees Brobbel
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  7. Johan J. Kerkkamp
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  8. Paul J. Voogd
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  9. A. V. G. Bruschke
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Baur, L.H.B., Schipperheyn, J.J., van der Wall, E.E. et al. Regional myocardial shape alterations in patients with anterior myocardial infarction. Int J Cardiac Imag 12, 89–96 (1996). https://doi.org/10.1007/BF01880739

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  • DOI: https://doi.org/10.1007/BF01880739

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