Myocardial viability independently influences left ventricular diastolic function in the early phase after acute myocardial infarction.
BACKGROUND
After acute myocardial infarction, a broad range of left ventricular (LV) end-diastolic pressure (LVEDP) is expected because of chamber remodeling. However, intrinsic characteristics of the infarcted tissue (necrosis or viability) may also play a role. We aimed to evaluate whether myocardial viability (Mviab) has an influence on LVEDP.


METHODS
One hundred twenty-three consecutive patients with acute myocardial infarction underwent low-dose dobutamine echocardiography (5-10 microg/kg/min) to assess Mviab. Mviab was quantitatively evaluated by the variation of Delta wall motion score index. Patients underwent left heart catheterization with recording of LVEDP and a complete echocardiographic examination with measurement of LV volumes, ejection fraction, and mass.


RESULTS
The overall population (81% male; mean age 58 +/- 10 years) was divided into 2 groups according to the presence (group 1; 66 patients) or absence (group 2; 57 patients) of Mviab. LVEDP was higher in patients without Mviab (16 +/- 8 vs 20 +/- 7 mm Hg; P =.02). The multivariate analysis showed that Delta wall motion score index correlated with LVEDP (P =.01) independent of wall motion score index and LV end-systolic volume.


CONCLUSIONS
After acute myocardial infarction, LVEDP shows wide variability and is independently associated with Mviab.
Rossi
Andrea
A
Dipartimento di Scienze Biomediche e Chirurgiche, Sezione di Cardiologia, Universita' di Verona, Italy. Andrea.Rossi@univr.it
Cicoira
Mariantonietta
M
Anselmi
Maurizio
M
Golia
Giorgio
G
Latina
Loredana
L
Tinto
Monica
M
Zardini
Piero
P
Oh
Jae K
JK
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D013318:Stroke Volume / Q000502:physiology; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*