title: Diastolic Dyssynchrony in Acute ST Segment Elevation Myocardial Infarction and Relationship with Functional Recovery of Left Ventricle.
abstract: BACKGROUND
  Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known.
  
  
  METHODS
  Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated. Diastolic delay was calculated from onset of QRS complex to peak of E wave in tissue Doppler image and presented as maximal temporal difference between peak early diastolic velocity of 6 basal segments of LV (TeDiff). Study patients were compared with demographically matched control group.
  
  
  RESULTS
  Forty eight consecutive patients (55 ± 10 years, 88% male) and 24 controls (56 ± 6 years, 88% male) were included. TeDiff was higher in STEMI than in controls (35.9 ± 19.9 ms vs. 26.3 ± 6.8 ms,p= 0.025). Presence of DD was higher in STEMI than controls (58% vs. 33%,p= 0.046) according to calculated cut-off value (≥ 29 ms). There was no correlation between TeDiff and change in EDVI, ESVI, and LAVI at 6 months, however TeDiff and change in EF at 6 months was positively correlated (r = 0.328,p= 0.023). Patients with baseline DD experienced remodeling less frequently compared to patients without baseline DD (11% vs. 38%,p= 0.040) during follow-up.
  
  
  CONCLUSIONS
  STEMI disrupts diastolic synchronicity of LV. However, DD during acute phase of STEMI is associated with better recovery of LV thereafter. This suggests that DD is associated with peri-infarct stunned myocardium that is salvaged with primary intervention as well as infarct size.
authors.affiliation: Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Turan
authors.affiliation: Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Daşli
authors.affiliation: Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Erkol
authors.affiliation: Cardiology Department, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: İsmail
authors.initials: İ
authors.lastname: Erden
authors.affiliation: Cardiology Department, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Yelda
authors.initials: Y
authors.lastname: Başaran
keywords: Diastolic dyssynchrony; Myocardial infarction; Remodeling