Prognostic importance of diastolic function and filling pressure in patients with acute myocardial infarction

Doppler echocardiographic assessment of hemodynamics in the acute setting of AMI provides independent noninvasive prognostic information. This is particularly true in the subgroup of patients who have evidence of elevated LV filling pressures despite relatively preserved systolic function. Although ventricular remodeling and hyperactivity of the renin-angiotensin-aldosterone system most likely contribute to the excess mortality in these patients, further work is required to increase our understanding of the pathophysiology. As our knowledge expands, it is likely that this will lead to new opportunities to modify the excess risk and improve patient outcome.