Left ventricular end-diastolic pressure and risk of subsequent heart failure in patients following an acute myocardial infarction

Left ventricular end-diastolic pressure (LVEDP) is an important measure of ventricular performance and may identify patients at increased risk for developing late clinical symptoms of heart failure (HF). The primary outcome in this analysis of 744 patients from the Survival and Ventricular Enlargeme...

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Published inCongestive heart failure (Greenwich, Conn.) Vol. 13; no. 4; p. 209
Main Authors Mielniczuk, Lisa M, Lamas, Gervasio A, Flaker, Greg C, Mitchell, Gary, Smith, Sidney C, Gersh, Bernard J, Solomon, Scott D, Moyé, Lemuel A, Rouleau, Jean L, Rutherford, John D, Pfeffer, Marc A
Format Journal Article
LanguageEnglish
Published United States 01.07.2007
Subjects
Chi-Square Distribution
Coronary Angiography
Diastole - physiology
Echocardiography
Female
Heart Failure - diagnostic imaging
Heart Failure - etiology
Heart Failure - physiopathology
Humans
Linear Models
Male
Middle Aged
Myocardial Infarction - complications
Myocardial Infarction - physiopathology
Proportional Hazards Models
Prospective Studies
Risk Factors
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - physiopathology
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Summary:Left ventricular end-diastolic pressure (LVEDP) is an important measure of ventricular performance and may identify patients at increased risk for developing late clinical symptoms of heart failure (HF). The primary outcome in this analysis of 744 patients from the Survival and Ventricular Enlargement (SAVE) trial was the development of death or HF over a mean time of 36 months. The mean LVEDP for all patients was 23+/-9 mm Hg, and 75% of participants (n=558) had an LVEDP >15 mm Hg. Patients with an LVEDP >30 mm Hg (n=187) had the highest risk of death or HF (unadjusted hazard ratio, 1.40; 95% confidence interval [CI], 1.00-1.97) when compared with the other 2 cohorts combined (n=603). After adjustment for other known predictors of cardiac risk, LVEDP no longer remained significant (adjusted hazard ratio, 1.12; 95% CI, 0.77-1.65). Elevated LVEDP is common following myocardial infarction; however, it is not an independent predictor of subsequent HF risk. The variability in LVEDP is not fully explained by infarct size and atherosclerotic burden.
ISSN:1527-5299
DOI:10.1111/j.1527-5299.2007.06624.x