Key result
Higher pulmonary artery end-diastolic pressure (>20 mmHg) in acute myocardial infarction was associated with larger infarct size (99g), reduced cardiac function (P<0.001), and 60% mortality.
Observational (n=82)
In acute myocardial infarction, elevated pulmonary artery end-diastolic pressure correlates with larger infarct size, impaired cardiac function, and increased mortality.
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Admission PAEDP may aid early AMI risk stratification; leaves open its added value beyond enzyme-derived infarct size.
In 82 patients with acute myocardial infarction, observed haemodynamic changes were compared with the average maximal serum enzyme rise and the infarct size, as calculated from serial determinations of creatine phosphokinase concentration. For this purpose, patients were divided into 3 groups according to their pul- monary artery end-diastolic pressure at the time of admission. There were I9 patients in group I with pulmonary artery end-diastolic pressure <12 mmHg; they had an average infarction size of I7g and no impairment of cardiac function. In the 35 patients in group II with pulmonary artery end-diastolic pressure 12 to 20 mmHg, the pressure was raised to a mean value of I5-4 0o4 mmHg with a slight decrease of car- diac index (2.50.1 1./min per mi2) and left ventricular stroke work index (5144 47g iM/M2). Loss of myocardium in group II was 42g and mortality was 21 per cent. There were 28 patients in group III with pulmonary artery end-diastolic pressure > 20 mmHg, who had an average infarct size of 99g. Cardiac index (19 0-2 1./min/m2), and stroke work index (27.5 5-7g iM/iM2) declined significantly (P< o.ooi). Mean end-diastolic pressure rose to 28-3 xI@ mmHg. Mortality in group III (6o%) was mainly due to cardio- genic shock.
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Mathey et al. (1974) conducted an observational in acute myocardial infarction (n=82). Pulmonary artery end-diastolic pressure at admission vs. Different levels of pulmonary artery end-diastolic pressure (<12 mmHg, 12-20 mmHg, >20 mmHg) was evaluated on Relation between haemodynamic changes, infarct size, and cardiac function (p=< 0.001). Higher pulmonary artery end-diastolic pressure (>20 mmHg) in acute myocardial infarction was associated with larger infarct size (99g), reduced cardiac function (P<0.001), and 60% mortality.
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