Does baseline color Doppler echocardiography predict heart failure and assess ventricular remodeling in patients with acute myocardial infarction undergoing percutaneous coronary intervention?
Baseline color Doppler echocardiography, particularly LVEF, effectively predicts the 6-month risk of heart failure in patients with acute myocardial infarction undergoing PCI.
Purpose: To evaluate the role of color Doppler echocardiography in assessing ventricular remodeling and post-percutaneous coronary intervention (PCI) heart failure (HF) in patients with acute myocardial infarction (AMI). Methods: 81 AMI patients admitted to our hospital were selected for retrospective analysis, including 49 patients who underwent PCI (research group, RG) and 32 patients who did not undergo PCI (control group, CG). Both groups of patients were followed up for 6 months. Left ventricular (LV) end-diastolic volume (LVEDV), LV end-diastolic dimension (LVEDD), LV end-diastolic dimension (LVESD) and LV ejection fraction (LVEF) were measured using a Philips iE33 ultrasound system. To assess ventricular remodeling dynamically, LVEDVI was additionally measured at 7 days (T2), 1 month (T3), and 6 months (T4) after treatment, and ΔLVEDVI was calculated as the difference between LVEDVI at each follow‑up time point and the baseline value at T1. Receiver operating characteristic (ROC) curve was used to analyze the sensitivity of LVEDD, LVESD and LVEF to predict HF. Multivariate logistic regression analysis was used to analyze the factors associated with HF progression. Results: Elevated ΔLVEDVI levels was observed in both cohorts at T2-T4 compared with the value at T1, with significantly lower ΔLVEDVI in the RG than in the CG at each time point ( P < 0.05). Among the 11 patients who developed post-PCI HF in the research group, significant increases in LVEDD and LVESD and a significant decrease in LVEF ( P < 0.05). Based on ROC analysis, color Doppler echocardiography demonstrated excellent diagnostic performance for post-PCI HF ( P < 0.05). The number of coronary artery lesions, Gensini score, hypertension, and color Doppler echocardiography results at T1 were independent risk factors for post-PCI HF ( P < 0.05). Conclusion: Color Doppler echocardiography demonstrated excellent performance in evaluating ventricular remodeling and post-PCI HF in AMI patients and may provide a reliable reference for future clinical management of AMI. Keywords: color doppler echocardiography, acute myocardial infarction, heart failure, ventricular remodeling
Ren et al. (Mon,) studied this question.