title: Assessment of ST-elevation myocardial infarction-related diastolic dysfunction with compensatory rise in left atrial ejection force.
abstract: BACKGROUND
  It is well known that patients with ST-elevation myocardial infarction (STEMI) show both systolic and diastolic left ventricular dysfunction. The aim of this study was to assess post-myocardial infarction diastolic dysfunction using left atrial ejection force (LAEF) in patients treated with primary percutaneous coronary intervention (PCI).
  
  
  RESULTS
  We enrolled 58 patients presenting with STEMI who were treated with primary PCI and 23 healthy subjects as a control group. A detailed transthoracic echocardiogram, including mitral flow velocities, tissue Doppler mitral annular velocities, and left atrial (LA) phasic volumes, was performed in both groups. We also measured the level of B-type natriuretic peptide (BNP). LAEF was calculated using the formula: 0.5 × P × Mitral orifice area × (Peak A velocity)(2) . Correlations between variables were studied using "Pearson and Spearman's rho" test. In the test group, we found that the level of BNP in the plasma, E/E' ratio, and the LA volume measurements were higher than that of the control group, and those differences were statistically significant. LAEF was increased in patients with myocardial infarction (MI); moderately correlated to BNP (r = 0.383 and P = 0.001) and E/E' (r = 0.473 and P = 0.001), and strongly correlated to A-wave velocity (r = 0.731 and P = 0.001). LAEF was also negatively correlated to E/A ratio (r = -0.419 and P = 0.001) and LVEF (r = -0.339 and P = 0.003).
  
  
  CONCLUSIONS
  Impaired diastolic function in STEMI affects LA and increased LAEF is one of its manifestations. LAEF may also have diagnostic importance in diastolic dysfunction, but these findings should be confirmed by further studies.
authors.affiliation: Kosuyolu Heart & Research Hospital, Istanbul, Turkey. cemcardio@hotmail.com
authors.forename: Cem
authors.initials: C
authors.lastname: Dogan
authors.forename: Onur
authors.initials: O
authors.lastname: Omaygenc
authors.forename: Suzan
authors.initials: S
authors.lastname: Hatipoglu
authors.forename: Ruken B
authors.initials: RB
authors.lastname: Bakal
authors.forename: Aykut
authors.initials: A
authors.lastname: Demirkiran
authors.forename: M Yunus
authors.initials: MY
authors.lastname: Emiroglu
authors.forename: Tulay
authors.initials: T
authors.lastname: Bayram
authors.forename: Nihal
authors.initials: N
authors.lastname: Ozdemir
mesh_terms: D001794:Blood Pressure; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*