[Prognostic values for in-hospital event rate of early E/Em in patients with acute myocardial infarction].
OBJECTIVE
To assess the prognostic values for in-hospital event rate of tissue Doppler imaging (TDI) parameter (E/Em) after acute myocardial infarction.


METHODS
A total of 289 patients with acute myocardial infarction were retrospectively examined. Their clinical data and echocardiograms were obtained. Clinical events were recorded. Patients were divided into two groups according to the value of ratio of early transmitral flow velocity to early diastolic velocity of mitral annulus (E/Em): Group E/Em < 10 (n = 152) and Group E/Em ≥ 10 (n = 137). Clinical characteristics, echocardiographic parameters and the rate of cardiac events were compared. Predictors of heart failure were identified by multivariate Logistic regression analysis.


RESULTS
On echocardiography, the patients with an E/Em ratio ≥ 10 had statistically larger left atrial diameter [(39.1 ± 6.2) vs (36.0 ± 4.4) mm, P = 0.000] and left ventricular end diastolic diameter [(52.3 ± 7.3)vs (49.2 ± 5.2) mm, P = 0.000]. Worse systolic functions were found in group E/Em ≥ 10: left ventricular ejection fraction (LVEF) [(48.3 ± 11.7)% vs (56.7 ± 9.7)%, P = 0.000]. Systolic velocities of mitral annulus (Sm) [(6.6 ± 1.7) vs (8.6 ± 2.2) cm/s, P = 0.000]. Em [(6.4 ± 1.9) vs (9.4 ± 2.4) cm/s, P = 0.000] was statistically lower than that of E/Em < 10 group. Killip classes on admission were statistically higher in group E/Em ≥ 10 than those of the other group [(1.7 ± 0.9) vs (1.2 ± 0.6), P = 0.000]. So were as the ratio of heart failure (38.5% vs 13.8%, P = 0.000) and in-hospital mortality rate (4.4% vs 0.8%, P = 0.000). Logistic regression analysis demonstrated that the independent risk factors of heart failure included the value of E/Em and LVEF.


CONCLUSIONS
Early E/Em is probably a powerful predictor for left ventricular remodeling and in-hospital heart failure in patients after acute myocardial infarction.
Department of Cardiology, Peking University Third Hospital & Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China.
Ying
Y
Nie
Bao-Xia
BX
Chen
Xin-Heng
XH
Feng
Zhao-Ping
ZP
Li
Wei-Hong
WH
Li
Lei
L
Li
Wei
W
Gao
D003971:Diastole; D015150:Echocardiography, Doppler; D006801:Humans; D008943:Mitral Valve; D013599:Systole; D016277:Ventricular Function, Left