Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Predictors of Recovery of Left Ventricular Systolic Dysfunction after Acute Myocardial Infarction: From the Korean Acute Myocardial Infarction Registry and Korean Myocardial Infarction Registry

  • Oh, Pyung Chun (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University) ;
  • Choi, In Suck (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University) ;
  • Ahn, Taehoon (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University) ;
  • Moon, Jeonggeun (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University) ;
  • Park, Yeonjeong (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University) ;
  • Seo, Jong Goo (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University) ;
  • Suh, Soon Yong (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University) ;
  • Ahn, Youngkeun (Division of Cardiology, Department of Internal Medicine, Chonnam National University) ;
  • Jeong, Myung Ho (Division of Cardiology, Department of Internal Medicine, Chonnam National University)
  • Published : 2013.08.30
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Abstract

Background and Objectives: We investigated the predictors of the recovery of depressed left ventricular ejection fraction (LVEF) in patients with moderate or severe left ventricular (LV) systolic dysfunction after acute myocardial infarction (MI). Subjects and Methods: We analyzed 1307 patients, who had moderately or severely depressed LVEF (<45%) on echocardiography soon after acute MI and who underwent a follow-up echocardiography, among 27369 patients from the Korea Working Group on the Myocardial Infarction Registry. Patients were categorized into two groups according to recovery of LVEF: group I with consistently depressed LVEF (<45%) at the follow-up echocardiography and group II with a recovery of LVEF (${\geq}45%$). Results: Recovery of LV systolic dysfunction was observed in 51% of the subjects (group II, n=663; ${\Delta}LVEF$, $16.2{\pm}9.3%$), whereas there was no recovery in the remaining subjects (group I, n=644; ${\Delta}LVEF$, $0.6{\pm}7.1%$). In the multivariate analysis, independent predictors of recovery of depressed LVEF were as follows {odds ratio (OR) [95% confidence interval (CI)]}: moderate systolic dysfunction {LVEF ${\geq}30%$ and <45%; 1.73 (1.12-2.67)}, Killip class I-II {1.52 (1.06-2.18)}, no need for diuretics {1.59 (1.19-2.12)}, non-ST-segment elevation MI {1.55 (1.12-2.16)}, lower peak troponin I level {<24 ng/mL, median value; 1.55 (1.16-2.07)}, single-vessel disease {1.53 (1.13-2.06)}, and non-left anterior descending (LAD) culprit lesion {1.50 (1.09-2.06)}. In addition, the use of statin was independently associated with a recovery of LV systolic dysfunction {OR (95% CI), 1.46 (1.07-2.00)}. Conclusion: Future contractile recovery of LV systolic dysfunction following acute MI was significantly related with less severe heart failure at the time of presentation, a smaller extent of myonecrosis, or non-LAD culprit lesions rather than LAD lesions.

Keywords

References

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