[E wave deceleration time predicts left ventricular telediastolic pressure in acute myocardial infarction in patients with systolic dysfunction].
OBJECTIVE
Left ventricular end-diastolic pressure (LVEDP) is a useful parameter for the management of postinfarction patients. As the current methods of estimating LVEDP are invasive, the existence of non-invasive methods would be of great practical value. This study investigates the relation between LVEDP and Doppler parameters such as E wave deceleration time (EDT) and E/A ratio, at one month following an acute myocardial infarction.


METHODS
Eighty-nine patients with a first acute myocardial infarction treated with thrombolytic agents were studied. Doppler-echocardiography at 29 +/- 3 days and cardiac catheterization at 30 +/- 4 days postinfarction were performed. According to the ejection fraction (EF), the patients were divided into group 1 (n = 17) with EF < 45%, and group 2 (n = 72) with EF > 45%.


RESULTS
Overall, the E/A ratio showed a weak correlation with LVEDP (r = 0.32; p = 0.007), and EDT did not correlate with LVEDP. When patients from group 2 were analyzed, no correlation was found between LVEDP and either E/A or EDT. However, in patients from group 1, LVEDP strongly correlated with both EDT (r = -0.83; p = 0.00001) and E/A (r = 0.70; p = 0.003). Moreover, the sensitivity and specificity of an EDT of less than 150 ms in predicting a LVEDP > 20 mmHg was 100%.


CONCLUSIONS
We conclude that at the first month after a myocardial infarction EDT provides a non-invasive and useful parameter for estimating LVEDP in patients with systolic dysfunction.
Bodí Peris
V
V
Servicio de Cardiología, Hospital Clínico Universitario, Valencia.
Sanchis Forés
J
J
Insa Pérez
L
L
Chorro Gascó
F J
FJ
Muñoz Gil
J
J
Llácer Escorihuela
A
A
López Merino
V
V
D000368:Aged; D003627:Data Interpretation, Statistical; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left