title: [Prognostic evaluation of post-infarction patients using two-dimensional echocardiography, late ventricular potentials and baroreflex sensitivity].
abstract: BACKGROUND
  Although many variables are useful predictors of post-infarction mortality, their predictive positive values are weak when applied individually. The aim of this study was to determine the prognostic value of the combination of left ventricular ejection fraction, ventricular late potentials and baroreflex sensitivity.
  
  
  METHODS
  We studied 69 consecutive post-infarction patients. On the day of their discharge from the coronary unit, all patients underwent a two-dimensional echocardiography, to determine the ejection fraction as well as a high resolution electrocardiogram to detect late potentials. To a subset of 49 patients was carried out to learn their baroreflex sensitivity. The patients were followed for 14 +/- 7 months and the following cardiac end points were considered: sudden cardiac death, non sudden cardiac death and non-fatal episodes of sustained ventricular tachycardia or ventricular fibrillation.
  
  
  RESULTS
  There were 8 end points: 3 sudden cardiac deaths, 3 non sudden cardiac deaths and 2 successfully resuscitated sustained ventricular tachycardia episodes. The rate of fibrinolysis was 55%. An ejection fraction < 45%, the presence of late potentials and a baroreflex sensitivity < 3.0 msec/mmHg were univariate predictors with predictive positive values of 33%, 24% and 16%, respectively. When ejection fraction < 45%, late potentials and baroreflex sensitivity < 3.0 were combined, we found a significant increase in the positive predictive value (50%).
  
  
  CONCLUSIONS
  The combined determination of ejection fraction, ventricular late potentials and baroreflex sensitivity allows us to identify subset postinfarction patients with a high rate of cardiac complications.
authors.affiliation: Unidad de Cuidados Intensivos y Coronarios, Hospital Militar Universitario Vigil de Quiñones, Sevilla.
authors.forename: F
authors.initials: F
authors.lastname: García Díaz
authors.forename: R
authors.initials: R
authors.lastname: Vázquez García
authors.forename: J
authors.initials: J
authors.lastname: Fajardo López-Cuervo
authors.forename: F
authors.initials: F
authors.lastname: Díaz Ortuño
mesh_terms: D000368:Aged; D017704:Baroreflex / Q000502:physiology*; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D013318:Stroke Volume; D013997:Time Factors
vernacular_title: Valoración pronóstica pacientes postinfarto mediate la ecocardiografía bidimensional, los potenciales tardíos ventriculares y la sensibilidad barorrefleja.