title: Association diastolic function by echo and infarct size by magnetic resonance imaging after STEMI.
abstract: OBJECTIVE
  Left ventricular (LV) diastolic dysfunction is a predictor of increased morbidity and mortality; however, little is known about diastolic function and the degree of myocardial damage after myocardial infarction (MI). The aim was to assess the association between diastolic dysfunction by echocardiography and myocardial salvage assessed with cardiac magnetic resonance (CMR) imaging in patients with ST-segment elevation MI (STEMI).
  
  
  METHODS
  In a prospective study, echocardiography and CMR were performed in STEMI patients in the early post-MI phase assessing diastolic dysfunction according to E/A and E/e'average and area at risk, and after three months with measurement of final infarct size and salvage index. Linear regression analyses were performed testing the association of diastolic dysfunction with area at risk, final infarct size and salvage index.
  
  
  RESULTS
  A total of 193 patients (61 ± 11 years) were included. Median system delay (first medical contact to primary PCI) was 185 min, 123 patients (63%) had TIMI 0/1 flow before intervention and 85 (46%) sustained an anterior MI. In 74 patients (38%), diastolic function was normal. The presence of diastolic dysfunction was associated with larger area at risk of median 6.6% (p < 0.001), larger final infarct size of 4.5% (p < 0.001), and lower salvage index of -5.9% (p = 0.02) compared with patients with normal diastolic function.
  
  
  CONCLUSIONS
  Diastolic dysfunction in the early phase after STEMI is associated with more extensive myocardial damage and significantly poorer myocardial salvage after three months, and the presence of diastolic dysfunction acutely after STEMI may therefore be used as a marker of worse myocardial outcome.
authors.affiliation: a Department of Cardiology 2142 , the Heart Centre, Copenhagen University Hospital Rigshospitalet , Blegdamsvej 9 , Copenhagen , Denmark ;
authors.forename: Helle
authors.initials: H
authors.lastname: Søholm
authors.affiliation: a Department of Cardiology 2142 , the Heart Centre, Copenhagen University Hospital Rigshospitalet , Blegdamsvej 9 , Copenhagen , Denmark ;
authors.forename: Jacob
authors.initials: J
authors.lastname: Lønborg
authors.affiliation: a Department of Cardiology 2142 , the Heart Centre, Copenhagen University Hospital Rigshospitalet , Blegdamsvej 9 , Copenhagen , Denmark ;
authors.forename: Mads J
authors.initials: MJ
authors.lastname: Andersen
authors.affiliation: a Department of Cardiology 2142 , the Heart Centre, Copenhagen University Hospital Rigshospitalet , Blegdamsvej 9 , Copenhagen , Denmark ;
authors.forename: Niels
authors.initials: N
authors.lastname: Vejlstrup
authors.affiliation: a Department of Cardiology 2142 , the Heart Centre, Copenhagen University Hospital Rigshospitalet , Blegdamsvej 9 , Copenhagen , Denmark ;
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
authors.affiliation: a Department of Cardiology 2142 , the Heart Centre, Copenhagen University Hospital Rigshospitalet , Blegdamsvej 9 , Copenhagen , Denmark ;
authors.forename: Christian
authors.initials: C
authors.lastname: Hassager
authors.affiliation: b Department of Cardiology , Odense University Hospital , Denmark.
authors.forename: Jacob Eifer
authors.initials: JE
authors.lastname: Møller
mesh_terms: D000368:Aged; D004452:Echocardiography / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D017063:Outcome Assessment, Health Care / Q000379:methods; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology
keywords: Cardiac magnetic resonance imaging; diastolic dysfunction; echocardiography; myocardial infarction