Key result
Baseline diastolic dyssynchrony during the acute phase of STEMI was associated with a significantly lower incidence of left ventricular remodeling at 6 months compared to patients without it (11% vs. 38%).
Observational (n=72)
Single-blind (echocardiographic observer blinded to clinical status)
No
Diastolic dyssynchrony during the acute phase of STEMI is associated with better left ventricular functional recovery and less remodeling at 6 months, likely reflecting salvaged peri-infarct stunned myocardium.
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May indicate myocardial salvage in acute STEMI; leaves open prospective validation before clinical use.
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. CONCLUSION: 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.
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Turan et al. (2016) conducted an observational in ST segment elevation myocardial infarction (STEMI) (n=72). Baseline diastolic dyssynchrony (TeDiff ≥ 29 ms) vs. No baseline diastolic dyssynchrony was evaluated on Left ventricular remodeling at 6 months (p=0.040). Baseline diastolic dyssynchrony during the acute phase of STEMI was associated with a significantly lower incidence of left ventricular remodeling at 6 months compared to patients without it (11% vs. 38%).
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