0421: End-systolic wall stress to predict left ventricular remodeling after acute myocardial infarction

Objectivesto investigate whether the end-systolic wall stress is a predictor of left ventricular remodeling (LVR) in the aftermath of a myocardial infarction.BackgroundLVR in post myocardial infarction is hard to predict and associated with major adverse cardiovascular events.Methodswe calculate, among other parameters, end-systolic wall stress by three-dimensional MRI method in the aftermath of a revascularized MI. CMR was repeated at 3 months follow-up.ResultsThe analysis was performed on 169 patients. 13 patients presented LVR, including 11 due to anterior MI. In these 13 patients the data of the initial MRI were more pejorative: WS 25.9±6 vs 16.0±4 (p <0.001), LVEDVi 117.2±20ml/m2 vs 84.6±16ml/m2 (p<0.001), infarct size 46.6±20gr vs 22.8 ± 15gr (p<0.001), microvascular obstruction size 8.7±1.9gr vs 9±3gr (p<0.001) and LV ejection fraction 31.0±8% vs 49.0±9% (p<0.001). The initial global WS emerges as an independent predictor of LV remodeling (OR 1.298 [1.046 to 1.612], p<0.018) so as LVEDVi (OR 1.093 [1.013 to 1.180], p<0.022) and heart failure (OR 9.912 [1.094 to 89.842], p