Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction
BackgroundThe prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear.MethodsThis study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1530006/full |
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| author | Min-Wook Bae Seong-guen Moon Kyung-Tae Jung Won-Ho Kim Sang-Hyun Park Jihun Ahn Jin-Yong Hwang Seok Kyu Oh Seung Ho Hur Myung Ho Jung Kyu-Sun Lee |
| author_facet | Min-Wook Bae Seong-guen Moon Kyung-Tae Jung Won-Ho Kim Sang-Hyun Park Jihun Ahn Jin-Yong Hwang Seok Kyu Oh Seung Ho Hur Myung Ho Jung Kyu-Sun Lee |
| author_sort | Min-Wook Bae |
| collection | DOAJ |
| description | BackgroundThe prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear.MethodsThis study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post-AMI patients. Using data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH), 3,510 AMI patients who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed. LVEF and WMSI were assessed via echocardiography at baseline and one-year post-PCI. The primary outcome was major cardiovascular adverse events (MACE), a composite of all-cause death, recurrent myocardial infarction (MI), and rehospitalization for heart failure at three years.ResultsAmong 3,510 AMI patients, 1,561 (44.5%) showed improvement in both LVEF and WMSI at one year after PCI, 1,150 (32.8%) experienced improvement in either LVEF or WMSI, while 799 (22.8%) had deterioration in both. The incidence of MACE was significantly lower in patients with improvement in both LVEF and WMSI (7.8% vs. 12.5% vs. 17.1%, P < 0.001). These patients also exhibited the highest rate of LV reverse remodeling and the lowest rate of adverse remodeling. Both the random forest and logistic regression models identified changes in LVEF and WMSI as significant predictors of MACE and LV remodeling.ConclusionIn AMI patients, improvement in both LVEF and WMSI post-PCI was associated with a lower risk of MACE and a higher likelihood of LV reverse remodeling. These findings highlight the prognostic value of LVEF and WMSI changes in guiding long-term management strategies. |
| format | Article |
| id | doaj-art-5bcbb2e7a88a48a988ed880c5781a5d6 |
| institution | OA Journals |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-5bcbb2e7a88a48a988ed880c5781a5d62025-08-20T02:31:09ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15300061530006Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarctionMin-Wook Bae0Seong-guen Moon1Kyung-Tae Jung2Won-Ho Kim3Sang-Hyun Park4Jihun Ahn5Jin-Yong Hwang6Seok Kyu Oh7Seung Ho Hur8Myung Ho Jung9Kyu-Sun Lee10Department of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon, Republic of KoreaDepartment of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon, Republic of KoreaDepartment of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon, Republic of KoreaDepartment of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon, Republic of KoreaDepartment of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon, Republic of KoreaDepartment of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon, Republic of KoreaDepartment of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Republic of KoreaDepartment of Cardiology, Wonkwang University Hospital, Iksan, Republic of KoreaDepartment of Cardigology, Keimyung University Dongsan Medical Center, Daegu, Republic of KoreaDepartment of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of KoreaDepartment of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon, Republic of KoreaBackgroundThe prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear.MethodsThis study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post-AMI patients. Using data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH), 3,510 AMI patients who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed. LVEF and WMSI were assessed via echocardiography at baseline and one-year post-PCI. The primary outcome was major cardiovascular adverse events (MACE), a composite of all-cause death, recurrent myocardial infarction (MI), and rehospitalization for heart failure at three years.ResultsAmong 3,510 AMI patients, 1,561 (44.5%) showed improvement in both LVEF and WMSI at one year after PCI, 1,150 (32.8%) experienced improvement in either LVEF or WMSI, while 799 (22.8%) had deterioration in both. The incidence of MACE was significantly lower in patients with improvement in both LVEF and WMSI (7.8% vs. 12.5% vs. 17.1%, P < 0.001). These patients also exhibited the highest rate of LV reverse remodeling and the lowest rate of adverse remodeling. Both the random forest and logistic regression models identified changes in LVEF and WMSI as significant predictors of MACE and LV remodeling.ConclusionIn AMI patients, improvement in both LVEF and WMSI post-PCI was associated with a lower risk of MACE and a higher likelihood of LV reverse remodeling. These findings highlight the prognostic value of LVEF and WMSI changes in guiding long-term management strategies.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1530006/fullacute myocardial infarctionleft ventricular ejection fractionwall motion abnormalityLV reverse and adverse remodelingKorean acute myocardial infarction registry acute myocardial infarctionintravascular imaging-guided PCI |
| spellingShingle | Min-Wook Bae Seong-guen Moon Kyung-Tae Jung Won-Ho Kim Sang-Hyun Park Jihun Ahn Jin-Yong Hwang Seok Kyu Oh Seung Ho Hur Myung Ho Jung Kyu-Sun Lee Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction Frontiers in Cardiovascular Medicine acute myocardial infarction left ventricular ejection fraction wall motion abnormality LV reverse and adverse remodeling Korean acute myocardial infarction registry acute myocardial infarction intravascular imaging-guided PCI |
| title | Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction |
| title_full | Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction |
| title_fullStr | Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction |
| title_full_unstemmed | Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction |
| title_short | Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction |
| title_sort | prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction |
| topic | acute myocardial infarction left ventricular ejection fraction wall motion abnormality LV reverse and adverse remodeling Korean acute myocardial infarction registry acute myocardial infarction intravascular imaging-guided PCI |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1530006/full |
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