Association between Multilayer Left Ventricular Rotational Mechanics and the Development of Left Ventricular Remodeling after Acute Myocardial Infarction

Background The identification of patients at risk for developing left ventricular (LV) remodeling after acute myocardial infarction (AMI) has crucial prognostic implications. The aims of this study were (1) to investigate the relationship between peak subepicardial and subendocardial twist and infarct transmurality, as assessed using contrast-enhanced magnetic resonance imaging, and (2) to evaluate the association between peak subepicardial and subendocardial twist and LV remodeling 6 months after AMI. Methods A total of 213 patients with ST-segment elevation AMIs who underwent three-dimensional echocardiography for LV volumes and functional assessment and two-dimensional speckle-tracking analysis for the evaluation of LV twist (subendocardial vs subepicardial) were retrospectively included. A subgroup of 40 patients underwent magnetic resonance imaging within 2 months for infarct size quantification. Results Peak subepicardial twist was strongly related to infarct size (number of segments with transmural scar: r 2  = 0.526, P r 2  = 0.515, P r 2  = 0.379, P r 2  = 0.331, P P P P P  = .041) were independently associated with the development of LV remodeling. Conclusions Peak subepicardial twist strongly reflects infarct transmurality as assessed with magnetic resonance imaging and is independently associated with LV remodeling after AMI.