Dyslipidemia, Low Left Ventricular Ejection Fraction and High Wall Motion Score Index Are Predictors of Progressive Left Ventricular Dilatation After Acute Myocardial Infarction

Background and Objectives: Left ventricular (LV) remodeling is a heterogeneous process, involving both infarcted and non-infarcted zones, which affects wall thickness and chamber size, shape and function. Subjects and Methods: A total of 758 consecutive patients (62.8${\pm}$12.0 years, 539 males) with acute myocardial infarction (AMI), who were examined by echocardiography at admission and after 6 months. An increase in LV end-diastolic volume index >10% was defined as a progressive LV dilation. They were divided into two groups according to the extent of progressive LV dilatation during 6 months. Group I with progressive LV dilatation (n=154, 61.4${\pm}$11.0 years, 110 males) vs. group II without LV dilatation (n=604, 64.1${\pm}$12.0 years, 429 males). Results: The age and gender were no significant differences between two groups. The levels of glucose, creatinine, maximal creatine kinase (CK), CK-MB, troponin T and I were significantly increased in group I than in group II (p<0.05). Low ejection fraction (EF) and high wall motion score index (WMSI) were more common in group I than in group II (p<0.05). The presence of dyslipidemia {odds ratio (OR); 1.559, confidence interval (CI); 1.035-2.347, p=0.03}, low EF less than 45% (OR; 3.328, CI 2.099-5.276, p<0.01) and high WMSI above 1.5 (OR; 3.328, CI 2.099-5.276, p<0.01) were significant independent predictors of progressive LV dilatation by multivariate analysis. Conclusion: Dyslipidemia, decreased systolic function and high WMSI were independent predictors of LV remodeling process in patients with AMI.