Myocardial viability independently influences left ventricular diastolic function in the early phase after acute myocardial infarction

Background: After acute myocardial infarction, a broad range of left ventricular (LV) end-diastolic pressure (LVEDP) is expected because of chamber remodeling. However, intrinsic characteristics of the infarcted tissue (necrosis or viability) may also play a role. We aimed to evaluate whether myocardial viability (Mviab) has an influence on LVEDP. Methods: One hundred twenty-three consecutive patients with acute myocardial infarction underwent low-dose dobutamine echocardiography (5-10 μg/kg/min) to assess Mviab. Mviab was quantitatively evaluated by the variation of Δ wall motion score index. Patients underwent left heart catheterization with recording of LVEDP and a complete echocardiographic examination with measurement of LV volumes, ejection fraction, and mass. Results: The overall population (81% male; mean age 58 ± 10 years) was divided into 2 groups according to the presence (group 1; 66 patients) or absence (group 2; 57 patients) of Mviab. LVEDP was higher in patients without Mviab (16 ± 8 vs 20 ± 7 mm Hg; P = .02). The multivariate analysis showed that A wall motion score index correlated with LVEDP (P = .01) independent of wall motion score index and LV end-systolic volume. Conclusions: After acute myocardial infarction, LVEDP shows wide variability and is independently associated with Mviab.