December 2, 1997Open Access
View Full PaperEvaluation and prognostic significance of left ventricular diastolic function assessed by Doppler echocardiography in the early phase of a first acute myocardial infarction
Key Result
Mitral E deceleration time ≤ 130 ms and age were significant independent predictors of congestive heart failure development during the first week following a first acute myocardial infarction.
Study Design
Type
Cohort (n=65)
Structured PICO
Does early assessment of left ventricular diastolic function by Doppler echocardiography predict the development of congestive heart failure in patients with a first acute myocardial infarction?
P
Population
65 consecutive patients with a first acute myocardial infarction assessed within 1 hour of arrival in the coronary care unit, followed for the development of congestive heart failure during the first week.
E
Exposure
Pulsed Doppler echocardiography assessment of left ventricular diastolic function (transmitral and pulmonary venous flow velocities)
O
Outcome
Development of congestive heart failure during the first week following a first acute myocardial infarctionhard clinical
Early assessment of left ventricular diastolic function, specifically mitral E deceleration time ≤ 130 ms, helps identify patients at risk of developing congestive heart failure after a first acute myocardial infarction.
Abstract
AIM: To study the prognostic significance of left ventricular diastolic function evaluated by transmitral and pulmonary venous flow velocities obtained in the early phase of a first acute myocardial infarction in relation to later development of congestive heart failure. METHODS: Pulsed Doppler echocardiography of transmitral and pulmonary venous flow was assessed in 65 consecutive patients with a first myocardial infarction within 1 h of arrival in the coronary care unit. RESULTS: A univariate regression analysis identified age, left ventricular ejection fraction 1.5, peak pulmonary venous atrial flow velocity > or = 30 cm.s-1 and a difference between mitral and pulmonary venous atrial flow duration < 0 ms as variables significantly related to the development of congestive heart failure. However, in a multivariate analysis only mitral E deceleration time < or = 130 ms and age were significant independent variables related to the development of congestive heart failure during the first week following a first acute myocardial infarction. CONCLUSION: Assessment of left ventricular diastolic function complements measurements of systolic function in the evaluation of cardiac function, and mitral deceleration < or = 130 ms best identifies patients at risk of development of congestive heart failure following acute myocardial infarction.