Value of noninvasive techniques for predicting early complications in patients with clinical class II acute myocardial infarction.
Twenty-six consecutive patients with acute clinical class II myocardial infarction were prospectively evaluated to assess the ability of two-dimensional echocardiography and gated equilibrium radionuclide angiography to predict early morbidity and mortality. Within 48 hours of the onset of symptoms, right heart catheterization, two-dimensional echocardiography and radionuclide angiography were performed. Serious in-hospital complications developed in 7 patients (27%, Group I), while the remaining 19 patients (Group II) had no complications. Mean left ventricular stroke work index was the only hemodynamic variable that differed significantly between Group I and Group II (28 +/- 8 [standard deviation] vs. 39 +/- 13 g-m/m2, respectively, p less than 0.02). Also, Group I compared with Group II had a significantly lower mean left ventricular ejection fraction by two-dimensional echocardiography (26 +/- 5 vs. 51 +/- 10%, p less than 0.001) or by radionuclide angiography (29 +/- 9 vs. 46 +/- 12%, p less than 0.001). Similarly, Group I had a higher average wall motion index than Group II by both techniques (2.2 +/- 0.2 vs. 1.7 +/- 0.3, p less than 0.001 by two-dimensional echocardiography, and 2.1 +/- 0.3 vs. 1.7 +/- 0.3, p less than 0.001 by radionuclide angiography). Selected stepwise multiple regression analysis demonstrated that left ventricular ejection fraction or wall motion index, by two-dimensional echocardiography or radionuclide angiography, had additional value to a history of prior myocardial infarction for predicting in-hospital complications in patients with class II infarction.(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D004452:Echocardiography; D004562:Electrocardiography; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013318:Stroke Volume; D013667:Technetium; D013997:Time Factors
D013667:Technetium