Echocardiographic diastolic function evolution in patients with an anterior Q-wave myocardial infarction: insights from the REVE-2 study.

Joao Pedro Ferreira (1) , Christophe Bauters (2) , Romain Eschalier (3) , Zohra Lamiral (4) , Renaud Fay (5) , Olivier Huttin (3) , Nicolas Girerd (1) , Faiez Zannad (1) , Florence Pinet (2) , Patrick Rossignol (1)

1 CIC - Centre d'investigation clinique [Nancy]
2 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
3 CIC-EC - Centre d'investigation clinique - Epidémiologie clinique [Nancy]
4 CIC-P - Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
5 Service de Médecine Nucléaire [CHRU Nancy]

Background: Myocardial fibrosis plays a key role in the development of adverse left ventricular remodeling after myocardial infarction (MI). This study aimed to determine whether the circulating levels of BNP, collagen peptides, and galectin-3 are associated with diastolic function evolution (both deterioration and improvement) at 1-year after an anterior MI. Methods: The REVE-2 is a prospective multicenter study including 246 patients with a first anterior Q-wave MI. Echocardiographic assessment was performed at hospital discharge and ±1-year after MI. BNP, Galectin-3 and collagen peptides were measured ±1-month after MI. Left ventricular diastolic dysfunction (DD) was defined according to the presence of at least 2 criteria of echocardiographic parameters: septal e’<8 cm/s, lateral e’<10 cm/s and left atrial volume ≥34 mL/m2. Results: At baseline 87 (35.4%) patients had normal diastolic function and 159 (64.6%) patients had diastolic dysfunction. Follow-up of 61 patients among the 87 patients with normal diastolic function at baseline showed that 22 patients (36%) developed DD at 1-year post-MI. The circulating levels of PIIINP>6 mg/l (Odds Ratio, OR=5.29; 95%CI=1.05-26.66; p=0.044), Galectin-3>13 μg/l (OR=5.99; 95%CI=1.18-30.45; p=0.031), and BNP>82 ng/l (OR=10.25; 95%CI=2.36-44.50; p=0.002) quantified at 1-month post-MI were independently associated with 1-year DD. Follow-up of the 137 patients with DD at baseline among the 159 patients showed that 36 patients (26%) had a normalized diastolic function at 1-year post-MI. Patients with a BNP>82 ng/l were less likely to improve diastolic function (OR=0.06; 95%CI=0.01-0.28; p=0.0003). Conclusions. The present study suggests that circulating levels of PIIINP, Galectin-3 and BNP may be independently associated with new-onset DD in post-MI patients.

Domaines: Cardiologie et système cardiovasculaire

Joao Pedro Ferreira, Christophe Bauters, Romain Eschalier, Zohra Lamiral, Renaud Fay, et al.. Echocardiographic diastolic function evolution in patients with an anterior Q-wave myocardial infarction: insights from the REVE-2 study.. ESC Heart Failure, 2018, 6 (1), pp.70-79. ⟨10.1002/ehf2.12359⟩. ⟨hal-02262179⟩