Decreased atrioventricular plane displacement after acute myocardial infarction yields a concomitant decrease in stroke volume

Abstract

Acute myocardial infarction (AMI) can progress to heart failure, which has a poor prognosis. Normally, 60% of stroke volume (SV) is attributed to the longitudinal ventricular shortening and lengthening evident in the atrioventricular plane displacement (AVPD) during the cardiac cycle, but there is no information on how the relationship changes between SV and AVPD before and after AMI. Therefore, the aim of this study was to determine how SV depends on AVPD before and after AMI in two swine models. Serial cardiac magnetic resonance imaging was carried out before and 1–2 h after AMI in a microembolization model ( n = 12) and an ischemia-reperfusion model ( n = 14). A subset of pigs ( n = 7) were additionally imaged at 24 h and at 7 days. Cine and late gadolinium enhancement images were analyzed for cardiac function, AVPD measurements and infarct size estimation, respectively. AVPD decreased ( P < 0.05) in all myocardial regions after AMI, with a concomitant SV decrease ( P < 0.001). The ischemia-reperfusion model affected SV to a higher degree and had a larger AVPD decrease than the microembolization model (−29 ± 14% vs. −15 ± 18%; P < 0.05). Wall thickening decreased in infarcted areas ( P < 0.001), and A-wave AVPD remained unchanged ( P = 0.93) whereas E-wave AVPD decreased ( P < 0.001) after AMI. We conclude that AVPD is coupled to SV independent of infarct type but likely to a greater degree in ischemia-reperfusion infarcts compared with microembolization infarcts. AMI reduces diastolic early filling AVPD but not AVPD from atrial contraction. These findings shed light on the physiological significance of atrioventricular plane motion when assessing acute and subacute myocardial infarction. NEW & NOTEWORTHY The link between cardiac longitudinal motion, measured as atrioventricular plane displacement (AVPD), and stroke volume (SV) is investigated in swine after acute myocardial infarction (AMI). This cardiac magnetic resonance study demonstrates a close coupling between AVPD and SV before and after AMI in an experimental setting and demonstrates that this connection is present in ischemia-reperfusion and microembolization infarcts, acutely and during the first week. Furthermore, AVPD is equally and persistently depressed in infarcted and remote myocardium after AMI.

Ventricular longitudinal shortening is an independent predictor of death in heart failure patients with reduced ejection fraction

“…Of note, extracellular volume quantification was not available in our study population and may have provided prognostic information. Experimental data have shown that reduced AVPD after acute MI yields a concomitant decrease in SV 39 which also helps to understand why ventricular longitudinal shortening would be prognostic in ischemic heart failure.…”

Systolic and Diastolic Functions After a Brief Acute Bout of Mild Exercise in Normobaric Hypoxia

“…Actually, ventricular systole pulls down the atrio-ventricular plane, and it seems reasonable to assume that the displacement of this plane is an expression of the myocardial contractility (Höglund et al, 1988). In support to the notion that Sm is related to myocardial performance there are findings that mitral anulus systolic excursion is reduced in patients with ventricular dysfunction (Grue et al, 2018;Berg et al, 2020).…”

Continuous monitoring of left ventricular function in postoperative intensive care patients using artificial intelligence and transesophageal echocardiography

“…1 B). We based this criterion on reports showing that MAPSE from any wall reflects global LV function, not the regional LV function of that wall [ 23 – 26 ]. Then, we defined monitoring feasibility as how often we could reassess the same wall from the same patient during the ICU protocol.…”