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Myocardial viability independently influences left ventricular diastolic function in the early phase after acute myocardial infarction
Ist Teil von
Journal of the American Society of Echocardiography, 2002-12, Vol.15 (12), p.1490-1495, Article 1490
Ort / Verlag
United States: Mosby, Inc
Erscheinungsjahr
2002
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Background: After acute myocardial infarction, a broad range of left ventricular (LV) end-diastolic pressure (LVEDP) is expected because of chamber remodeling. However, intrinsic characteristics of the infarcted tissue (necrosis or viability) may also play a role. We aimed to evaluate whether myocardial viability (Mviab) has an influence on LVEDP. Methods: One hundred twenty-three consecutive patients with acute myocardial infarction underwent low-dose dobutamine echocardiography (5-10 μg/kg/min) to assess Mviab. Mviab was quantitatively evaluated by the variation of Δ wall motion score index. Patients underwent left heart catheterization with recording of LVEDP and a complete echocardiographic examination with measurement of LV volumes, ejection fraction, and mass. Results: The overall population (81% male; mean age 58 ± 10 years) was divided into 2 groups according to the presence (group 1; 66 patients) or absence (group 2; 57 patients) of Mviab. LVEDP was higher in patients without Mviab (16 ± 8 vs 20 ± 7 mm Hg; P =.02). The multivariate analysis showed that Δ wall motion score index correlated with LVEDP (P =.01) independent of wall motion score index and LV end-systolic volume. Conclusions: After acute myocardial infarction, LVEDP shows wide variability and is independently associated with Mviab. (J Am Soc Echocardiogr 2002;15:1490-5.)