Features of the course of the postinfarction period in patients with adverse left ventricular remodeling

Background . Adverse left ventricular remodeling (ALVR) after ST-segment elevation myocardial infarction (STEMI) is associated with the high risk of complications. Objective . Identification of laboratory parameters, structural and functional characteristics of arteries associated with ALVR after STEMI and revascularization. Design and methods . 141 patients were included. On days 7–9, after 24–48 weeks, an examination was performed. The endpoints were recorded for 192 weeks. Results . 125 patients were followed up, who were divided into groups: 1st “ALVR” — 63 patients with an increase in end-diastolic volume index by > 20 % and/ or end-systolic volume index by > 15 %; 2nd group “Without ALVR” — 62 people. After 48 weeks, in the 1st group, in patients with glomerular filtration rate (eGFR) < 90 ml/min/1.73 m 2 , the indicator increased by 12.2 %; in individuals with an initial eGFR ≥ 90 ml/min/1.73 m 2 , it decreased by 18.7 %. In patients without ALVR and initial eGFR < 90 ml/min/1.73 m 2 , the indicator increased by 6.2 %. Only in group 2, positive dynamics of endothelial function indicators was revealed. The odds ratio of adverse events in group 1 was 2.8 [1.3–6.1] compared with group 2 (p = 0.007). Conclusion . The development of ALVR after MI in the medium term was characterized by a deterioration in the filtration capacity of the kidneys and persistent endothelial dysfunction over 48 weeks, a high incidence of adverse events over 192 weeks.