Predicting Left Heart Failure after a Myocardial Infarction: A Preliminary Study of the Value of Echocardiographic Measures of Left Ventricular Filling and Wall Motion

Prediction of Heart Failure Post Myocardial Infarction: Comparison of Ejection Fraction, Transmitral Filling Parameters, and the Index of Myocardial Performance

“…Unlike previous studies, 8,9 patients who died did not demonstrate any greater abnormalities in diastolic function. They were older, had larger enzymatic infarcts, larger left ventricles, lower EF, and more likely to have an anterior infarct.…”

“…Early post‐MI, parameters of diastolic filling appear to correlate with LV filling pressures, but later may correlate with relaxation abnormalities 4 , 10 , 26 . The presence of restrictive filling predicted CHF and early mortality 8,9 . Restrictive filling was defined as E/A > 2 and DCT < 140 msec) 7,8 , 27 .…”

“…Diastolic filling parameters may vary from the abnormal relaxation pattern to the pattern of pseudonormal or restrictive filling. Both the restrictive and pseudonormal filling patterns have been associated with elevated LV filling pressures and an increased incidence of congestive heart failure (CHF) 5–9 . Of interest, the diastolic filling pattern immediately post MI may change over time to less restrictive diastolic filling patterns.…”

“…Of interest, the diastolic filling pattern immediately post MI may change over time to less restrictive diastolic filling patterns. Maintenance of the pseudonormal or restrictive pattern may be related to remodeling changes and the development of late CHF 4–10 . Although the pseudonormal filling pattern can be differentiated from normal diastolic filling by mitral annular tissue Doppler, color flow transmission velocities, or pulmonary venous inflow, 11–13 we believe that a reduced ejection fraction (EF) in the setting of an acute MI provides this differentiation without resorting to additional indices.…”

Congestive heart failure. Correlation between functional class and systolic and diastolic functions assessed by Doppler echocardiography

“…Controversy exists in the literature regarding the main determinants of heart failure functional class. Some studies have shown that the ability to perform physical exercises is related more to the patterns of diastolic filling of the left ventricle than to the indexes of systolic function [2][3][4] , whereas others have established a direct relationship between functional class and indexes of systolic function 5,6 . The more advanced functional classes (III and IV) are related to greater mortality 1,4,[6][7][8][9][10] .…”