Evaluation and prognostic significance of left ventricular diastolic function assessed by Doppler echocardiography in the early phase of a first acute myocardial infarction

• Published in: European heart journal Vol. 18; no. 12; pp. 1882 - 1889
• Main Authors: Poulsen, S. H., Jensen, S. E., Gøtzsche, O., Egstrup, K.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.12.1997
• Subjects: Aged; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Diastole; diastolic function; Doppler echocardiography; Echocardiography, Doppler; Female; Heart; Heart Failure - etiology; Hemodynamics; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - physiopathology; Prognosis; Prospective Studies; Ventricular Function, Left; Sonography; Human; Prognosis; Diastole; Infarct; Acute; Cardiovascular disease; Duplex ultrasonography; Coronary heart disease; Myocardial disease; Myocardium; Medical imagery; Early; Left ventricle performance
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/oxfordjournals.eurheartj.a015196

Aim To study the prognostic significance of left ventricular diastolic function evaluated by transmitral and pulmonary venous flow velocities obtained in the early phase of a first acute myocardial infarction in relation to later development of congestive heart failure. Methods Pulsed Doppler echocardiography of transmitral and pulmonary venous flow was assessed in 65 consecutive patients with a first myocardial infarction within 1 h of arrival in the coronary care unit. Results A univariate regression analysis identified age, left ventricular ejection fraction ≤45%, mitral E deceleration time ≤130 ms, E/A ratio >1·5, peak pulmonary venous atrial flow velocity ≥30 cm . s−1 and a difference between mitral and pulmonary venous atrial flow duration >0 ms as variables significantly related to the development of congestive heart failure. However, in a multivariate analysis only mitral E deceleration time ≤130 ms and age were significant independent variables related to the development of congestive heart failure during the first week following a first acute myocardial infarction. Conclusion Assessment of left ventricular diastolic function complements measurements of systolic function in the evaluation of cardiac function, and mitral deceleration ≤130 ms best identifies patients at risk of development of congestive heart failure following acute myocardial infarction.