[Comparison of two-dimensional echocardiography and hemodynamic monitoring in acute myocardial infarct].
The aim of this study was to assess if in patients with acute myocardial infarction, two-dimensional echocardiographic asynergy index is correlated to hemodynamic parameters. Furthermore, we compared how reliable the 2 methods are to identify patients at a high risk of developing early left ventricular failure. Fifty-four consecutive patients (43 males, 11 females, mean age: 61 +/- 13 years with acute myocardial infarction were studied using hemodynamic monitoring and 2D-echocardiography within 24 hours from admission. The 2D-echo asynergy index, calculated on a 14-segment left ventricular model, was significantly correlated to heart rate (r = 0.49, p less than 0.001), pulmonary capillary wedge pressure (r = 0.47, p less than 0.001), systemic vascular resistance (r = 0.47, p less than 0.001), cardiac index (r = -0.46, p less than 0.001) and left ventricular stroke work index (r = -0.63, p less than 0.001). Both the asynergy index and the hemodynamic parameters were correlated to Killip clinical classification. In the sub-group of 46 patients initially classified as belonging to Killip class I or II, the patients who later developed left ventricular failure or those in whom it worsened showed a higher asynergy index and a greater impairment of left ventricular function when compared to the patients with an uncomplicated clinical course. The sensitivity of an asynergy index greater than or equal to 1 in predicting early cardiac failure was 75%, the specificity was 64%, the positive predictive value was 43% and the negative predictive value was 88%.(ABSTRACT TRUNCATED AT 250 WORDS)
Previtali
M
M
Divisione di Cardiologia, IRCCS Policlinico S. Matteo, Pavia.
Lanzarini
L
L
Ferrario
M
M
Mussini
A
A
Tortorici
M
M
Poli
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015924:Blood Pressure Monitors; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D011379:Prognosis
Confronto fra ecocardiografia bidimensionale e monitoraggio emodinamico nell'infarto miocardico acuto.