End-systolic wall stress predicts post-discharge heart failure after acute myocardial infarction.

Summary Background Compensatory mechanisms activated after myocardial infarction include an increase in systolic wall stress (SWS) and activation of the neurohormonal system. Nevertheless, left ventricular ejection fraction (LVEF) and infarct size are the established primary predictors of outcome after ST-segment elevation myocardial infarction. Aims To assess the relative impact of various cardiac magnetic resonance (CMR) imaging variables, such as infarct size, LVEF and SWS, on pre- and post-discharge heart failure (HF). Methods CMR was performed in a prospective study involving 169 patients with first ST-segment elevation myocardial infarction. Common CMR findings, such as SWS, were computed. Results Mean SWS was 16.3 ± 5.1 × 10 3  N·m −2 , and was systematically higher in patients exhibiting either pre- or post-discharge HF (18.9 ± 5.7 and 21.3 ± 7.6 × 10 3  N·m −2 , respectively). SWS was moderately related to initial infarct size ( r  = 0.405; P Conclusion Regardless of LVEF and infarct size, SWS was shown to be an independent predictor of post-discharge HF after ST-segment elevation myocardial infarction.