Late recovery in left ventricular systolic function after discharge of patients with a first anterior myocardial infarction

SummaryBackgroundLeft ventricular systolic function is a useful indicator of in-hospital prognosis in patients with acute myocardial infarction. For long-term risk stratification, however, the variable degree of recovery that may occur during the ensuing period has also to be taken into account.AimsTo analyse the prevalence, time course, determinants and correlates of late left ventricular function recovery after myocardial infarction, from hospital discharge to 1-year follow-up, using systematic serial assessment of left ventricular function.MethodsData from 512 patients with a first anterior myocardial infarction included in two prospective studies on left ventricular remodelling (REVE and REVE-2) were analysed. Serial echocardiographic studies were performed before discharge, at 3 months and at 1 year after myocardial infarction. Left ventricular volumes, ejection fraction, and Wall Motion Score Index were determined at a core echocardiographic laboratory.ResultsIn both cohorts, there was a significant decrease in Wall Motion Score Index between discharge and 1 year (from 1.87±0.15 to 1.71±0.21 [P<0.0001] in REVE; and from 1.91±0.15 to 1.64±0.28 [P<0.0001] in REVE-2), indicating an improvement in systolic function. Left ventricular ejection fraction increased from 49.6±9.5% at baseline to 51.5±9.5% at 1 year in REVE (P<0.008), and from 49.8±8.3% to 55.5±9.8% in REVE-2 (P