Key result
Early systolic reverse flow on TTE after anterior AMI is linked to ~6-fold higher MACE risk.
Why the study?
It was unknown whether early systolic reverse flow detected noninvasively by transthoracic echocardiography predicts chronic cardiac function, functional recovery, and major adverse cardiac events in patients with anterior AMI.
Does the presence of early systolic reverse flow on TTE predict chronic cardiac function and MACE in patients with anterior AMI?
Cohort (n=84)
Does the presence of early systolic reverse flow on TTE predict chronic cardiac function and MACE in patients with anterior AMI?
Absolute Event Rate: 19.1% vs 3.3%
p-value: p=.02
Detection of early systolic reverse flow in the LAD using non-invasive transthoracic echocardiography early after anterior AMI predicts poor functional recovery and increased risk of MACE.
May flag higher MACE risk after anterior AMI on routine TTE; leaves open incremental prognostic value pending validation.
BACKGROUND: Predicting the cardiac function in chronic phase of acute myocardial infarction (AMI) patients is important. Previous studies showed that the presence of early systolic reverse flow (ESRF) in coronary flow measured with a Doppler guide wire is a predictor of worsening chronic phase function in patients with anterior AMI. We routinely examined the coronary flow velocity (CFV) of the distal left anterior descending artery (LAD) using transthoracic echocardiography (TTE) in AMI patients. The aim of this study is to investigate whether the ESRF in TTE is associated with the chronic cardiac function, recovery of cardiac function, and the incidence of major adverse cardiac events (MACE) in patients with anterior AMI. METHODS: We enrolled 84 patients with their first anterior AMI. Using TTE, we recorded the CFV of distal LAD within 5 days after primary percutaneous coronary intervention. Patients were divided into two groups, ESRF + group (ESRF was detected in TTE: 21 cases) and ESRF- group (ESRF was not detected in TTE: 63 cases). We compared chronic cardiac function in TTE, changes in cardiac function in acute and chronic phase (ΔLVEF, ΔLVDd), and the incidence of MACE. RESULTS: The incidence of MACE in ESRF-group was lower than that in ESRF + group (3.3% vs 19.1% P = .02). LVEF in chronic phase in ESRF- group was higher than that in ESRF + group (54.1 ± 5.6% vs 40.4 ± 6.2% P < .001). ΔLVDd was smaller in ESRF-group than ESRF + group (-0.62 ± 4.0 mm vs +5.06 ± 3.4 mm P = .003). CONCLUSION: Early systolic reverse flow in TTE is a predictor of chronic cardiac function and incidence of MACE in patients with anterior AMI.
No takes yet. Share an insight, caveat, or question.
Watanabe et al. (2021) conducted a cohort in anterior acute myocardial infarction (n=84). Early systolic reverse flow (ESRF) on transthoracic echocardiography vs. Absence of ESRF was evaluated on incidence of major adverse cardiac events (MACE) (p=.02). The presence of early systolic reverse flow on TTE in patients with anterior AMI was associated with a higher incidence of MACE compared to its absence (19.1% vs 3.3%, P=0.02).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: