Morphofunctional picture of the left ventricle in different variants of post-infarction remodeling

Oleynikov VE, Salyamova LI, Maximov DB, et al. Morphofunctional picture of the left ventricle in different variants of post-infarction remodeling. Russian Cardiology Bulletin. 2026;21(1):75‑83. (In Russ.)
https://doi.org/10.17116/Cardiobulletin20262101175

Подписка 2026 Кардиологический вестник (Russian Cardiology Bulletin)

Использование инфографики авторами научных работ

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OBJECTIVE

To study morphofunctional characteristics of the myocardium in patients with different variants of LV remodeling 24 weeks after myocardial infarction and revascularization.

MATERIAL AND METHODS

A total of 105 patients with myocardial infarction were included. Primary percutaneous coronary intervention was performed in 67 (63.8%) patients, pharmacoinvasive revascularization in 38 (36.2%) patients. Cardiac magnetic resonance imaging (MRI), speckle tracking echocardiography (EchoCG) were performed on the 7^th—10^th day and after 24 weeks.

RESULTS

Follow-up was completed for 92 (87.6%) patients. According to EchoCG results, patients were divided into groups: 1 — 44 patients with increased end-diastolic volume index (iEDV) >20% and/or end-systolic volume index (iESV) >15% after 24 weeks (pathological remodeling (PR) of the LV); 2 — 27 patients with iEDV <20% in combination with dynamics of iESV from -15% to +15% (slowly progressive remodeling (SR) of the LV); 3 — 21 patients with regression of iESV≥15% (reverse remodeling (RR) of the LV). According to cardiac MRI, scar mass in the PRLV group decreased by 4.8% (p=0.005), SRLV — by 48.2% (p=0.017), RRLV — by 44.4% (p=0.040). The incidence of microvascular obstruction decreased with SRLV by 2.7 times (p=0.006).

According to EchoCG after 24 weeks, the RRLV group was characterized by global work efficiency increase by 2.7% (p=0.021), global work index by 28.1% (p<0.001), and global constructive work by 27.3% (p<0.001). These parameters did not change in comparison groups.

CONCLUSION

Cardiac MRI and speckle-tracking EchoCG allow quantitative assessment of morphofunctional picture of postinfarction cardiac sclerosis. Cardiac MRI revealed shrinkage of infarction zones that was most pronounced in the SRLV group. In the RRLV group, speckle-tracking EchoCG revealed favorable increase in myocardial work indicators.

Keywords:

postinfarction left ventricular remodeling

magnetic resonance imaging

ischemic injury pattern

speckle-tracking echocardiography

myocardial work

Authors:

Oleynikov V.E.

Penza State University, Penza, Russia

ORCID: 0000-0002-7463-9259

Salyamova L.I.

Penza State University, Penza, Russia

ORCID: 0000-0001-7130-0316

Maximov D.B.

Zakharyin Clinical Hospital No. 6, Penza, Russia

ORCID: 0009-0002-2257-2109

Alimov N.V.

Penza State University, Penza, Russia

ORCID: 0009-0007-3984-2271

Averyanova E.V.

Penza State University, Penza, Russia

ORCID: 0000-0001-9925-2096

Plaksin N.S.

Penza State University, Penza, Russia

ORCID: 0009-0001-9551-7701

Donetskaya N.A.

Penza State University, Penza, Russia;
Burdenko Penza Regional Clinical Hospital, Penza, Russia

ORCID: 0000-0001-6423-6889

Vdovkin A.V.

Burdenko Penza Regional Clinical Hospital, Penza, Russia

ORCID: 0000-0002-0142-381X

Received:

01.07.2025

Accepted:

15.10.2025

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