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


METHODS
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.


RESULTS
A univariate regression analysis identified age, left ventricular ejection fraction < or = 45%, mitral E deceleration time < or = 130 ms, E/A ratio > 1.5, peak pulmonary venous atrial flow velocity > or = 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 < or = 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.


CONCLUSIONS
Assessment of left ventricular diastolic function complements measurements of systolic function in the evaluation of cardiac function, and mitral deceleration < or = 130 ms best identifies patients at risk of development of congestive heart failure following acute myocardial infarction.
Poulsen
S H
SH
Department of Medicine, Haderslev Hospital, Denmark.
Jensen
S E
SE
Gøtzsche
O
O
Egstrup
K
K
D000368:Aged; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006439:Hemodynamics; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D016277:Ventricular Function, Left