Function of remote non-infarcted myocardium after STEMI: analysis with cardiovascular magnetic resonance

To evaluate remote myocardial function after ST-elevation myocardial infarction (STEMI) and the impact of infarct size (IS) using cardiovascular magnetic resonance (CMR). 161 patients and 15 controls underwent CMR at 1st week and 6th month after STEMI. Using the 17-segments model, segments were categorized into infarcted, adjacent and remote myocardium. Relative systolic wall thickening (SWT, %) was assessed using the centerline method. IS (% of left ventricular mass) was determined in late enhancement imaging. Overall, in remote myocardium, SWT was comparable (83 +/- 32) to controls (77 +/- 25, P = .5) and did not increase significantly (P = .2) at the 6th month (88 +/- 35, P = .3 vs. control). When IS was categorized into tertiles (< 13.6%, (n = 49), 13.7-28.2%, (n = 60), > 28.2%, (n = 52)), SWT in the remote area at the 1st week was not different from controls, regardless of infarct size (p between .2 and .8 for all tertiles). At 6 months, SWT was larger compared to controls only in small infarctions (98 +/- 34 vs. 77 +/- 25, P = .03). In medium and large infarctions there was no difference in SWT of the remote area compared to controls (87 +/- 33 and 79 +/- 34, P = .3 and P = .09) and there was no significant increase at 6 months (P between .2 and .9). In remote myocardium there was no difference in contractility compared to controls after STEMI. After 6 month a slight hypercontractility can only be observed in small infarctions. In medium and large infarctions no difference of SWT in remote myocardium compared to controls can be observed.