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

1997; Oxford University Press; Volume: 18; Issue: 12 Linguagem: Inglês

10.1093/oxfordjournals.eurheartj.a015196

1522-9645

Steen Hvitfeldt Poulsen, Svend Eggert Jensen, Ole Gøtzsche, Kenneth Egstrup,

Heart Failure Treatment and Management

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. 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. 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. 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.