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European Heart Journal 2002 23(7):536-542; doi:10.1053/euhj.2001.2820
Copyright © 2002 by the European Society of Cardiology.
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Prediction of 6 months left ventricular dilatation after myocardial infarction in relation to cardiac morbidity and mortality. Application of a new dilatation model to GISSI-3 data

P.J de Kama, G.L Nicolosib, A.A Voorsc, M.P van Den Berga, J Brouwera, D.J van Veldhuisena, S Barlerad, A.P Maggionie, P Giannuzzif, P.L Temporellif, R Latinid and W.H van Gilstg,f1

a University Hospital Groningen, The Netherlands
b Cardiologia, Ospedale Civile Pordenone, Italy
c Anthonius Hospital Nieuwegein, The Netherlands
d Department of Cardiovascular Research, ‘Mario Negri’ Milano, Italy
e Associazione Nazionale Medici-Cardiologi Ospedalieri, Firenze, Italy
f Divisione di Cardiologia Fondazione Salvatore Maugeri, IRCCS, Veruno, Italy
g Department of Clinical Pharmacology, University of Groningen, The Netherlands

revised June 11, 2001; accepted June 13, 2001

Abstract

Aims To predict the long-term left ventricular volume index early after myocardial infarction and to investigate the relationship between long-term left ventricular dilatation risk and clinical outcome.

Methods and Results By applying a previously developed dilatation model, we predicted the 6-month left ventricular volume index early after myocardial infarction (median 9 days) in 13679 GISSI-3 patients, to identify patients at high risk of long-term left ventricular dilatation. The left ventricular systolic and diastolic volume indexes at 6 months were predicted with r=0·72 and r=0·68, respectively, in the subgroup of patients in whom a pre-discharge echo was available (n=7842). Patients predicted to be at risk for long-term left ventricular dilatation had an increased risk of mortality (RR 1·87, 95% CI: 1·48 to 2·36) and heart failure at 6 months (RR 2·59, 95% CI:2·04 to 3·28), but no increased risk of reinfarction at 6 months (RR 1·12, 95% CI: 0·87 to 1·45) or of angina pectoris (RR 1·07, 95% CI: 0·95 to 1·20).

Conclusion Our prediction of long-term left ventricular dilatation, obtained by applying our new dilatation model in over 13000 GISSI-3 patients, correlated well with mortality and heart failure after myocardial infarction. Therefore, our new dilatation model may contribute to more efficient risk stratification early after myocardial infarction.

Key Words: Prediction model, left ventricular dilatation, 2-D echocardiography, myocardial infarction, mortality, cardiac morbidity

f1 Correspondence: Prof. W. H. van Gilst, University of Groningen, Department of Clinical Pharmacology, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.

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