Acta Medica Colombiana
Print version ISSN 0120-2448
SENIOR, Juan Manuel et al. Cardiac remodeling in patients with myocardial infarction secondary to penetrating heart wound. Acta Med Colomb [online]. 2012, vol.37, n.1, pp. 6-13. ISSN 0120-2448.
The mechanism and magnitude of the cardiac remodelling process in traumatic acute myocardial infarction remain unknown. Objective: to characterize and quantify the process in patients who developed traumatic myocardial infarction secondary to penetrating heart wound, and to compare it with patients without infarction. Methods: a prospective, observational cohort study was carried out in patients with myocardial infarction secondary to penetrating heart wound. The exposed cohort comprised all patients with traumatic myocardial infarction and the non-exposed cohort comprised the patients without infarction. Results: there were 31 male patients, two female patients, mean age was 31 years. More than 90 percent of the wounds were caused by a sharp, pointed weapon. At the baseline, the ejection fraction and fractional shortening were significantly lower in the patients with infarction (52% vs 70%, p< 0.0001; 27.6% vs 35.1%, p< 0.001, respectively). At the six-month follow-up, the only variable significantly different between the two groups was the fractional shortening (30.18 vs. 34.72, p < 0.05). Patients with penetrating heart wound and with secondary traumatic AMI have a RR of 2.67 (95% CI 0.72-9.89) of developing eccentric hypertrophy after six months. Conclusions: patients with penetrating heart wounds with and without infarction showed a tendency to develop a remodelling process with eccentric hypertrophy. The differences encountered, however, are not significant and a longer follow-up is required, as well as a larger number of patients. (Acta Med Colomb 2012; 37: 6-13).
Keywords : myocardial infarction; traumatic; remodelling, echocardiography.