Comparison of usefulness of left ventricular diastolic versus systolic function as a predictor of outcome following primary percutaneous coronary angioplasty for acute myocardial infarction

Tasneem Zehra Naqvi, Sriram Padmanabhan, Farhad Rafii, Hahn K. Hyuhn, James Mirocha

Research output: Contribution to journalArticle

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Abstract

Left ventricular (LV) diastolic function is an important predictor of morbidity and mortality after acute myocardial infarction (AMI). We evaluated the role of diastolic function in predicting in-hospital events and LV ejection fraction (EF) 6 months after a first AMI that was treated with primary percutaneous coronary intervention (PCI). We prospectively enrolled 59 consecutive patients who were 60 ± 15 years of age (48 men), presented at our institution with their first AMI, and were treated with primary PCI. Patients underwent 2-dimensional and Doppler echocardiography, including tissue Doppler imaging of 6 basal mitral annular regions within 24 hours after primary PCI and were followed until discharge. Clinical and echocardiographic variables at index AMI were compared with a combined end point of cardiac death, ventricular tachycardia, congestive heart failure, or emergency in-hospital surgical revascularization. Follow-up echocardiographic assessment was performed at 6 months in 24 patients. During hospitalization, 3 patients died, 7 developed congestive heart failure, 4 had ventricular tachycardia, and 1 required emergency surgical revascularization. Stepwise logistic regression analysis showed the ratio of early mitral inflow diastolic filling wave (E) to peak early diastolic velocity of non-infarct-related mitral annulus (p <0.01) (E′) and mitral inflow E-wave deceleration time (p <0.02) to be independent predictors of in-hospital cardiac events (generalized R2 = 0.66). In a stepwise multiple linear regression model, independent predictors of follow-up LVEF were mitral inflow deceleration time (R2 = 0.39, p = 0.002), baseline LVEF (R2 = 0.54, p <0.02), and mitral inflow peak early velocity/mitral annular peak early velocity (or E/E′) of infarct annulus (R2 = 0.66, p = 0.02). In conclusion, in patients who are treated with primary PCI for a first AMI, E/E′ velocity ratio and mitral inflow E-wave deceleration time are strong predictors of in-hospital cardiac events and of LVEF at 6-month follow-up.

Original languageEnglish (US)
Pages (from-to)160-166
Number of pages7
JournalAmerican Journal of Cardiology
Volume97
Issue number2
DOIs
StatePublished - Jan 15 2006
Externally publishedYes

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Angioplasty
Percutaneous Coronary Intervention
Myocardial Infarction
Deceleration
Ventricular Tachycardia
Linear Models
Emergencies
Heart Failure
Doppler Echocardiography
Left Ventricular Function
Stroke Volume
Hospitalization
Logistic Models
Regression Analysis
Morbidity
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Comparison of usefulness of left ventricular diastolic versus systolic function as a predictor of outcome following primary percutaneous coronary angioplasty for acute myocardial infarction. / Naqvi, Tasneem Zehra; Padmanabhan, Sriram; Rafii, Farhad; Hyuhn, Hahn K.; Mirocha, James.

In: American Journal of Cardiology, Vol. 97, No. 2, 15.01.2006, p. 160-166.

Research output: Contribution to journalArticle

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