Serial changes in left ventricular diastolic indexes derived from Doppler echocardiography after anterior wall acute myocardial infarction

M, Algom; Schlesinger, Z

doi:10.1016/s0002-9149(99)80778-4

Cited by 13 publications

(7 citation statements)

References 5 publications

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“…This cutoff point has been shown to be consistent with restrictive hemodynamics and a powerful independent predictor of unfavorable outcome after acute myocardial infarction and idiopathic dilated cardiomyopathy. 9,11,12,14 To avoid the effects of acute ischemia on LV filling patterns, 6 we chose to measure baseline DT on day 3 after the index infarction.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Several investigators have in fact observed an upward shift in the pressure-volume curve during AMI or ischemia as a result of an increase in resistance to LV filling or increased chamber stiffness. 21 Furthermore, in a few experimental studies, chamber stiffness increased within 24 hours after AMI, reverting to normal after several days.…”

Section: Diastolic Function and Amimentioning

confidence: 99%

“…These findings may provide the critical linkage between restrictive filling pattern and clinical events after AMI observed in some observational studies. 11,12,14 …”

Section: Serial Changes Of Filling Pattern and LV Remodelingmentioning

confidence: 99%

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Doppler-Derived Mitral Deceleration Time

et al. 1999

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Background-The relation between remodeling and left ventricular (LV) diastolic function has not yet been fullyinvestigated. The aim of this study was to determine whether early assessment of Doppler-derived mitral deceleration time (DT), a measure of LV compliance and filling, may predict progressive LV dilation after acute myocardial infarction (AMI). Methods and Results-Fifty-one patients (aged 61Ϯ11 years; 6 women) with anterior AMI successfully treated with direct coronary angioplasty underwent 2-dimensional and Doppler echocardiographic examinations within 24 hours of admission, at days 3, 7, and 30 and 6 months after the index infarction. Mitral flow velocities were obtained from the apical 4-chamber view with pulsed Doppler. End-diastolic volume index (EDVI) and end-systolic volume index (ESVI) were calculated with the Simpson's rule algorithm. Patients were divided according to the DT duration assessed at day 3 in 2 groups: group 1 (nϭ33) with DT Ͼ130 ms and group 2 (nϭ18) with DT Յ130 ms. Patency and restenosis rate at 6 months were similar between the 2 groups (94% group 1 vs 89% group 2; Pϭ0.52; 27% group 1 vs 33% group 2; Pϭ0.64, respectively). LV volume indexes were similar in both groups at baseline (EDVI: 71Ϯ3 group 1 vs 70Ϯ3 mL/m 2 group 2, Pϭ0.42; ESVI: 43Ϯ3 group 1 vs 48Ϯ3 mL/m 2 group 2, Pϭ0.13, respectively). From day 3 on, LV volume indexes progressively increased in group 2 and were significantly larger than those of group 1 at 6 months (LVEDVI 61Ϯ3 group 1 vs 104Ϯ6 mL/m 2 group 2, Pϭ0.00001; LVESVI 31Ϯ3 group 1 vs 73Ϯ6 mL/m 2 group 2, Pϭ0.00001, respectively). A significant inverse correlation was found between DT and changes in EDVI at 6 months (rϭϪ0.68; PϽ0.0000001). By stepwise multiple regression analysis among several clinical, demographic, angiographic, and echocardiographic variables, DT was the most powerful predictor of EDVI changes at 6 months (Pϭ0.02). Conclusions-These data suggest that early estimation (day 3) of Doppler-derived mitral DT provides a simple and accurate mean to predict late LV dilation after reperfused AMI. (Circulation. 1999;99:230-236.)

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Section: Discussionmentioning

confidence: 99%

Section: Diastolic Function and Amimentioning

confidence: 99%

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Doppler-Derived Mitral Deceleration Time

et al. 1999

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“…Among others, this is the detection of the restrictive type DD with the apparent decrease in the deceleration time of the early diastolic transmitral flow (DT) to less than 130 ms [17][18][19]. Several researchers showed that notwithstanding the correlation of the speed of early to the advanced transmitral flow (E/A), the DT slowing down in the post-infarction patients is the sign of the elevated pressure in the LV and leads to the increase of MI size [20][21][22]. This data is confirmed by Nijland F. and al., who informed that survival rates within one and three years after MI were only 50% and 22% correspondingly [23].…”

Section: Introductionmentioning

confidence: 99%

Effect of Primary Stenting of Coronary Arteries on Clinical Course and Remodeling of the Left Ventricle in Patients With Acute St Segment Elevation Myocardial Infarction (Results After 12 Months)

et al. 2020

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The aim: To determine the predictive effect of primary stenting of coronary artery on the clinical course and features of left ventricular remodeling in patients with acute myocardial infarction (MI) with ST segment elevation and LV diastolic dysfunction (DD) in the remote period (12 months). Materials and methods: The study included 80 patients with STEMI who undergo primary PCI (group 1) and 20 patients with STEMI who did not undergo myocardial revascularization (group 2). In both groups, the levels of NT-proBNP were determined, echocardiography, bicycle ergometry; quality of life was determined according to SAQ questionnaire scales; marked cardiovascular complications. Patients were re-examined after 12 months. Results: The average level of NT-proBNP for 5 days and 12 months of patients in group 1 significantly decreased – 434.6 ± 36.3 and 122.8 ± 4.13 g / ml (p <0.001), indicating a less pronounced late remodeling of LV in patients undergoing revascularization with STEMI. Diastolic function was evaluated by E/A and DT. After 12 months, the 1st group was markedly lower than E/A and DT compared to the 2nd – 0.76 ± 0.03 and 198 ± 4.7 m / s and 1.49 ± 0.01 and 135 , 3 ± 2.91 m/s, respectively (p <0.05), which characterizes a decrease in the parameters of the DD by the type of the relaxation processes of the left ventriculi. Patients in Group 1, according to SAQ scales, had better quality of life and higher exercise tolerance at I-II level than patients without revascularization. Conclusions: In patients with STEMI, after a primary stenting of coronary artery, a significantly lower NT-proBNP level and less pronounced DD manifestations in the long-term (12 months) period demonstrated a better tolerance to physical activity and improved quality of life, as determined by the SAQ questionnaire and a lower rate of development cardiovascular complications.

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“…Doppler echocardiography has provided a rapid, feasible, and simple noninvasive method of assessing LV filling in various cardiac diseases 9 in which diastolic abnormalities have been observed, including AMI 10,11,12,13 and allows the assessment of regional diastolic performance and dynamics of the left ventricular myocardium. Temporal dyssynchrony between normal and ischemic myocardium may result in impaired left ventricular relaxation and filling and regional dyssynchrony would improve after normalization of myocardial perfusion in the ischemic zone.…”

mentioning

confidence: 99%

Echocardiographic Evaluation of Left Ventricular Diastolic Function after Percutaneous Coronary Intervention in Patients with Acute STEMI

Kavirayani¹,

Gudivada²

2020

jebmh

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BACKGROUND Although percutaneous coronary intervention (PCI) is an excellent therapy for coronary artery disease, the effects of PCI on left ventricular diastolic function have not been systematically investigated in patients of Acute ST Elevation Myocardial Infarction (STEMI) in our population. The aim of this study was to investigate the reversibility of these diastolic abnormalities and improvement in left ventricular diastolic function by using echocardiographic diastolic parameters in patients with Acute STEMI in the setting of PCI and thus determine the effects of improved myocardial perfusion on impaired left ventricular diastolic abnormalities. METHODS A total of 100 consecutive patients admitted to Intensive Coronary Care Unit (ICCU), was included in the study. Echocardiography was done before PCI and 48 hours after PCI, to evaluate the indices of LV diastolic function in these patients. RESULTS The mean age of the patients was 52.04 ± 9.49 years, and majority of patients were males (84%). All had mild to moderate degree of left ventricular diastolic dysfunction. Mitral E wave velocity (63.41 cm/s ± 19.93 before treatment versus 71.51 cm/s ± 9.56, 48 hours after treatment), the peak velocity of late filling due to atrial contraction (mitral A wave velocity) (75.93 cm/s ± 20.3 before treatment vs. 78.96 cm/s ± 24.18, 48 hours after treatment), E/A ratio (1.03 ± 0.3 before treatment vs. 0.98 ± 0.24, 48 hours after treatment) showed improvement after PCI. After PCI deceleration time (DT) decreased (210.15 msec ± 47.43 before treatment versus 201.64 msec ± 28.15, 48 hours after treatment), and the difference was statistically significant (p<0.001). It is notable that early diastolic mitral annular velocity (E') improved significantly 48 hours after PCI (5.81 cm/s ± 1.65 before treatment vs. 7.96 cm/s ± 1.95, 48 hours after treatment, p < 0.001). E/ E2 ratio showed significant change 48 hours after PCI; it was statistically significant (10.17 ± 2.26 before treatment vs. 8.83 ± 1.7, 48 hours after treatment p<0.001). CONCLUSIONS Improvement in some indices of left ventricular diastolic function after PCI suggests that PCI can be an effective modality of treatment for diastolic dysfunction caused by myocardial ischemia and revascularization can restore diastolic properties of the heart after the insult in STEMI patients and thus prevent their progression to HFPEF.

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Serial changes in left ventricular diastolic indexes derived from Doppler echocardiography after anterior wall acute myocardial infarction

Cited by 13 publications

References 5 publications

Doppler-Derived Mitral Deceleration Time

Doppler-Derived Mitral Deceleration Time

Effect of Primary Stenting of Coronary Arteries on Clinical Course and Remodeling of the Left Ventricle in Patients With Acute St Segment Elevation Myocardial Infarction (Results After 12 Months)

Echocardiographic Evaluation of Left Ventricular Diastolic Function after Percutaneous Coronary Intervention in Patients with Acute STEMI

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