Left Ventricular Preejection Period and Ejection Time in Patients with Acute Myocardial Infarction

Hodges, Morrison; Halpern, Barry L.; Friesinger, Gottlieb C.; Dagenais, Gilles R.

doi:10.1161/01.cir.45.5.933

Cited by 49 publications

(22 citation statements)

References 26 publications

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“…In another 51 patients with acute myocardial infarction, the mean PEP was elevated on the first day of myocardial infarction but was within normal limits thereafter (21). PEP did not prove useful in predicting outcome because in the 8 patients who died, 3 had short PEP values and 2 patients had a normal PEP (21). The present study reconfirmed the significant correlation of %PEP, %ET and PEP/ET with LV EF, and between PEP/ET and Ea/Ees.…”

Section: T a B L E 1 I N -H O S P I T A L Ch A R A C T E R I S T I mentioning

confidence: 44%

“…In 38 patients with acute transmural myocardial infarction, mean PEP values on the first and second days of myocardial infarction were significantly longer in patients who died than in the survivors (9). In another 51 patients with acute myocardial infarction, the mean PEP was elevated on the first day of myocardial infarction but was within normal limits thereafter (21). PEP did not prove useful in predicting outcome because in the 8 patients who died, 3 had short PEP values and 2 patients had a normal PEP (21).…”

Section: T a B L E 1 I N -H O S P I T A L Ch A R A C T E R I S T I mentioning

confidence: 91%

“…Although the systolic time intervals can be used to assess LV function and ventriculo-arterial coupling, the prognostic value in heart failure patients remains to be demonstrated (9,20,21). In 38 patients with acute transmural myocardial infarction, mean PEP values on the first and second days of myocardial infarction were significantly longer in patients who died than in the survivors (9).…”

Section: T a B L E 1 I N -H O S P I T A L Ch A R A C T E R I S T I mentioning

confidence: 99%

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Electromechanical Activation Time in the Prediction of Discharge Outcomes in Patients Hospitalized with Acute Heart Failure Syndrome

et al. 2010

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Objective Left ventricular systolic time intervals, including pre-ejection period (PEP), ejection time (ET), and their ratio (PEP/ET), is determined by systolic and diastolic function and ventriculo-arterial coupling. We investigated the usefulness of the electromechanical activation time [(EMAT) PEP minus isovolumic contraction time] in the prediction of cardiac mortality or re-hospitalization for heart failure in patients with the acute heart failure syndrome (AHFS). Patients and Methods A total of 45 patients (71.9±16.1 years old) hospitalized for AHFS were enrolled. Systolic time intervals and EMAT normalized by cardiac cycle length (%) were measured separately by separate automated acoustic devices. All parameters were assessed within 24 hours of admission, before discharge, and 2 weeks after discharge. Results During a mean follow-up of 242±156 days, 20 patients (44%) incurred adverse cardiovascular events including 18 re-hospitalizations for heart failure and 2 cardiovascular deaths. Using uni-variate Cox regression analysis, at admission %EMAT and %PEP, pre-discharge %EMAT, and post-discharge %EMAT significantly predicted post-discharge cardiovascular events with hazard ratios and 95% confidence intervals of 1.75(1.13-2.70), 1.67(1.02-2.70), 1.87 (1.10-3.17) and 2.50 (1.58-3.97) per 1-SD increment, respectively. The predictions remained significant after adjustment for age, sex, left ventricular ejection fraction, E/E´by Doppler echocardiography, and serum N-terminal pro-brain natriuretic peptide. Conclusion EMAT measured during the hospitalization course is useful in the prediction of cardiovascular outcomes in patients with AHFS independent of left ventricular ejection fraction, E/E´, and serum N-terminal pro-brain natriuretic peptide.

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Section: T a B L E 1 I N -H O S P I T A L Ch A R A C T E R I S T I mentioning

confidence: 44%

Section: T a B L E 1 I N -H O S P I T A L Ch A R A C T E R I S T I mentioning

confidence: 91%

Section: T a B L E 1 I N -H O S P I T A L Ch A R A C T E R I S T I mentioning

confidence: 99%

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Electromechanical Activation Time in the Prediction of Discharge Outcomes in Patients Hospitalized with Acute Heart Failure Syndrome

et al. 2010

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“…19) In the present study, the Doppler index appeared to be more reliable in separating normal individuals from coronary artery disease than systolic time intervals (Fig.7). This is demonstrated by the findings that there is less overlapping between the 2 groups when the Doppler index is used.…”

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confidence: 56%

Blood Flow Velocity in the Carotid Artery as a Measure of Myocardial Contractility

et al. 1975

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SUMMARYAn attempt was made to derive a useful noninvasive index to evalute a change in myocardial contractile state using transcutaneous Doppler flow-velocity curve from the carotid artery.In 5 mongrel dogs and in 43 patients with various heart disease, Doppler flow velocity curves were obtained from the ascending aorta intravascularly using a Doppler catheter and/or from carotid artery transcutaneously using a Doppler probe. The first derivative of left ventricular pressure (dp/dt) and electrocardiogram (ECG) were recorded simultaneously. The following 3 indices were measured from the Doppler flowvelocity curves: (1) maximum acceleration of blood flow (dv/dt), (2) time from onset of ejection to peak flow (time-to-peak), (3) time interval between the beginning of Q wave of ECG to the peak of Doppler flow velocity curve (ECG Q-Doppler peak). Among these 3 indices, only ECG QDoppler peak demonstrated a significant correlation between the values measured intravascularly and transcutaneously. Also, only ECG QDoppler peak showed significant correlation with maximum of dp/dt (max dp/dt). Since ECG Q-Doppler peak showed correlation with heart rate, the difference between observed and predicted ECG Q-Doppler peak (zJECG Q-Doppler peak) was calculated to exclude the effect of heart rate. Predicted value of ECG Q -Doppler peak was calculated from the regression equation between heart rate and ECG Q: Doppler peak in the separate experiments. There was a significant correlation between 4ECG QDoppler peak and max dp/dt.In 15 patients with coronary artery disease and in 16 healthy subjects, 1ECG Q-Doppler peak and the other noninvasive method (systolic time intervals) were measured. JECG Q -Doppler peak showed better result in the separation of 2 groups than by systolic time intervals. It

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“…[1][2][3][4][5][6] Although these so-called "systolic time intervals" can now be retrieved at the bedside in most instances, they are unobtainable in certain patients because of technical difficulties in recording either the heart sounds or the indirect carotid pulses. An alternative noninvasive method, therefore, seemed desirable.…”

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confidence: 99%

Systolic time intervals by echocardiography.

Stefadouros¹,

Witham²

1975

Circulation

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SUMMARYTechnical difficulties in recording phonocardiogram or indirect carotid pulse occasionally preclude determination of the systolic time intervals. Accordingly, an alternative method was tested in 52 patients, using high-speed strip chart recording of the aortic valve echocardiogram. Satisfactory records were obtained in 36. The interval from opening to closing of the aortic valve (ejection time) was subtracted from the interval between the Q wave of the electrocardiogram and the closing of the aortic valve (total electromechanical systole) to provide the pre-ejection period. When these intervals and the pre-ejection period/ejection time ratio were compared to corresponding values obtained by conventional methods from the simultaneously recorded phonocardiograms and indirect carotid pulses, a high degree of correlation (r > 0.97) was found. Differences between the two methods for each interval were insignificant, being greatest in the case of the ejection time but never exceeding 16 msec. These findings indicate that the echocardiogram of the aortic valve provides an alternative, noninvasive method for determination of the systolic time intervals whenever the usual methods fail.

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Left Ventricular Preejection Period and Ejection Time in Patients with Acute Myocardial Infarction

Abstract: SUMMARYThe phases of systole were measured in 51 patients with acute myocardial infarction and three control groups: (1) a group of 40 patients without heart disease, (2)

Cited by 49 publications

References 26 publications

Electromechanical Activation Time in the Prediction of Discharge Outcomes in Patients Hospitalized with Acute Heart Failure Syndrome

Electromechanical Activation Time in the Prediction of Discharge Outcomes in Patients Hospitalized with Acute Heart Failure Syndrome

Blood Flow Velocity in the Carotid Artery as a Measure of Myocardial Contractility

Systolic time intervals by echocardiography.

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