Why the study?
Does velocity propagation of early diastole predict left ventricular remodelling in patients after a first acute myocardial infarction?
Does velocity propagation of early diastole predict left ventricular remodelling in patients after a first acute myocardial infarction?
Velocity propagation of early diastole is a useful echocardiographic marker for predicting late left ventricular remodelling after a first myocardial infarction.
Vp ≤35 cm/s was associated with late LV remodelling after AMI; hypothesis-generating and needs prospective validation before clinical use.
PURPOSE: Velocity propagation (Vp) of early diastole is a known method for the evaluation of left ventricular (LV) diastolic function. Our purpose was to determine whether Vp is a valuable tool to characterize patients after acute myocardial infarction and LV remodelling (LVR). METHODS: M-mode, two-dimensional and Doppler echocardiography were performed in 71 patients within the first 2 days, 1, 3 and 6 months after acute myocardial infarction. We measured the left atrium, LV diameters and volumes, peak early and late velocity (E, A) deceleration time, Vp, annular velocity (e) and calculated E/e. The patients were divided in two groups: (A) without early LVR (n=39) and (B) with early LVR (n=32). RESULTS: In the first evaluation, Vp was similar in both groups (36.37 vs. 35.49 cm/s, P=0.513). Late LVR (LLVR) (44%) had developed in patients from group A with significantly lower early Vp compared with patients without LLVR (31.52 vs. 40.12 cm/s, P=0.001), with persist values even after 6 months (29.41 vs. 40.85 cm/s, P=0.001). The values of Vp were similar in the first 2 days in patients from group B with developing (78%) and nondeveloping LLVR (35.29 vs. 36.60 cm/s, P=0.614). Differences became significant after 6 months (31.71 vs. 41.80 cm/s, P=0.001). The values of Vp of 35 cm/s or less from the first week in both groups correlated with LLVR (B=3.27, P=0.015). Changing of LV volumes significantly correlated with Vp; for end-diastolic volume/body surface area (r=0.21, P=0.041) and end-systolic volume/body surface area (r=0.30, P=0.014). CONCLUSION: In this study, Vp was the only valuable Doppler echocardiographic tool that reflected early LVR and LLVR.
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Celic et al. (2009) studied this question.
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