ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1530006
Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction
Provisionally accepted
Min-Wook Bae1
Kyu-Sun Lee1*
Seong-guen Moon1Kyung-Tae Jung1Won-Ho Kim1Sang-Hyun Park1Jihun Ahn1Jin-Yong Hwang2Seok Kyu Oh3Seung Ho Hur4
Myung Ho Jeong5- 1Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
- 2College of Medicine, Gyeongsang National University, Jinju, South Gyeongsang, Republic of Korea
- 3Wonkwang University Medical Center, Iksan, Republic of Korea
- 4Keimyung University Dongsan Medical Center, Daegu, North Gyeongsang, Republic of Korea
- 5Chungnam National University Hospital, Gwangju, Daejeon, Republic of Korea
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The prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear.This study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post-AMI patients. Using data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH), 3,510 AMI patients who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed. LVEF and WMSI were assessed via echocardiography at baseline and one-year post-PCI. The primary outcome was major cardiovascular adverse events (MACE), a composite of all-cause death, recurrent myocardial infarction (MI), and rehospitalization for heart failure at three years.Among 3,510 AMI patients, 1,561 (44.5%) showed improvement in both LVEF and WMSI at one year after PCI, 1,150 (32.8%) experienced improvement in either LVEF or WMSI, while 799 (22.8%) had deterioration in both. The incidence of MACE was significantly lower in patients with improvement in both LVEF and WMSI (7.8% vs. 12.5% vs. 17.1%, P < 0.001).These patients also exhibited the highest rate of LV reverse remodeling and the lowest rate of adverse remodeling. Both the random forest and logistic regression models identified changes in LVEF and WMSI as significant predictors of MACE and LV remodeling.In AMI patients, improvement in both LVEF and WMSI post-PCI was associated with a lower risk of MACE and a higher likelihood of LV reverse remodeling. These findings highlight the prognostic value of LVEF and WMSI changes in guiding long-term management strategies.
Keywords: acute myocardial infarction, left ventricular ejection fraction, Wall motion abnormality, LV reverse and adverse remodeling, Korean Acute Myocardial Infarction Registry Acute myocardial infarction, Intravascular imaging-guided PCI, Beta-blocker therapy, and LV remodeling
Received: 18 Nov 2024; Accepted: 24 Apr 2025.
Copyright: © 2025 Bae, Lee, Moon, Jung, Kim, Park, Ahn, Hwang, Oh, Hur and Jeong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kyu-Sun Lee, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
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