Wall motion score index and ejection fraction for risk stratification after acute myocardial infarction

2006 ◽  
Vol 151 (2) ◽  
pp. 419-425 ◽  
Author(s):  
Jacob E. Møller ◽  
Graham S. Hillis ◽  
Jae K. Oh ◽  
Guy S. Reeder ◽  
Bernard J. Gersh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ejection Fraction ◽  
Risk Stratification ◽  
Wall Motion ◽  
Wall Motion Score Index ◽  
Score Index

scholarly journals Effect of Ischaemic Postconditioning on Recovery of Left Ventricular Contractile Function after Acute Myocardial Infarction

2012 ◽  
Vol 40 (3) ◽  
pp. 1082-1088 ◽  
Author(s):  
Cm Zhao ◽  
Xj Yang ◽  
Jh Yang ◽  
Xj Cheng ◽  
X Zhao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ejection Fraction ◽  
Wall Motion ◽  
Contractile Function ◽  
Left Ventricular ◽  
Control Group ◽  
Wall Motion Score Index ◽  
Lv Ejection Fraction ◽  
Score Index

OBJECTIVE: This study investigated whether ischaemic postconditioning can improve recovery of myocardial contractile function in acute myocardial infarction patients 1 week and 6 months after angioplasty. METHODS: A total of 62 patients undergoing direct percutaneous coronary intervention after acute myocardial infarction were randomly assigned to receive four episodes of inflation and deflation of the angioplasty balloon in the early reperfusion period (postconditioned group, n = 32), or no additional intervention (control group, n = 30). Two-dimensional size and left ventricular (LV) global and regional contractile functions were then evaluated by echocardiography at 1 week and 6 months after angioplasty. RESULTS: At 1 week, there were no significant differences in left atrial diameter, LV end-diastolic diameter, LV end-diastolic volume, cardiac output, LV ejection fraction or wall motion score index between the two groups. At 6 months, LV ejection fraction was significantly increased and the wall motion score index significantly reduced in the postconditioned group compared with the control group. CONCLUSION: Ischaemic postconditioning can improve long-term LV contractile function 6 months after reperfusion following acute myocardial infarction.

scholarly journals Short early filling deceleration time on day 1 after acute myocardial infarction is associated with short and long term left ventricular remodelling

Heart ◽  
2001 ◽  
Vol 85 (5) ◽  
pp. 527-532
Author(s):  
P Otašević ◽  
A N Nešković ◽  
Z Popović ◽  
A Vlahović ◽  
D Bojić ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Wall Motion ◽  
Left Ventricular ◽  
Cardiac Mortality ◽  
Ventricular Remodelling ◽  
Wall Motion Score Index ◽  
Left Ventricular Remodelling ◽  
Score Index ◽  
Deceleration Time

OBJECTIVETo assess the relations between early filling deceleration time, left ventricular remodelling, and cardiac mortality in an unselected group of postinfarction patients.DESIGN AND PATIENTSProspective evaluation of 131 consecutive patients with first acute myocardial infarction. Echocardiography was performed on day 1, day 2, day 3, day 7, at three and six weeks, and at three, six, and 12 months after infarction. According to deceleration time on day 1, patients were divided into groups with short (< 150 ms) and normal deceleration time (⩾ 150 ms).SETTINGTertiary care centre.RESULTSPatients with a short deceleration time had higher end systolic and end diastolic volume indices and a higher wall motion score index, but a lower ejection fraction, in the year after infarction. These patients also showed a significant increase in end diastolic (p < 0.001) and end systolic volume indices (p = 0.007) during the follow up period, while ejection fraction and wall motion score index remained unchanged. In the group with normal deceleration time, end diastolic volume index increased (p < 0.001) but end systolic volume index did not change; in addition, the ejection fraction increased (p = 0.002) and the wall motion score index decreased (p < 0.001). One year and five year survival analysis showed greater cardiac mortality in patients with a short deceleration time (p = 0.04 and p = 0.02, respectively). In a Cox model, which included initial ejection fraction, infarct location, and infarct size, deceleration time on day 1 was the only significant predictor of five year mortality.CONCLUSIONSA short deceleration time on day 1 after acute myocardial infarction can identify patients who are likely to undergo left ventricular remodelling in the following year. These patients have a higher one year and five year cardiac mortality.

scholarly journals Superiority of wall motion score index over left ventricle ejection fraction in predicting cardiovascular events after an acute myocardial infarction

2016 ◽  
Vol 8 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Alfonso Jurado-Román ◽  
Pilar Agudo-Quílez ◽  
Belén Rubio-Alonso ◽  
Javier Molina ◽  
Belén Díaz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Wall Motion ◽  
Myocardial Damage ◽  
Composite Endpoint ◽  
Left Ventricle Ejection Fraction ◽  
Wall Motion Score Index ◽  
Score Index

Background: There are few data on the prognostic significance of the wall motion score index compared with left ventricle ejection fraction after an acute myocardial infarction. Our objective was to compare them after the hyperacute phase. Methods: Transthoracic echocardiograms were performed in 352 consecutive patients with myocardial infarction, after the first 48 hours of admission and before hospital discharge (median 56.3 hours (48.2–83.1)). We evaluated the ability of the wall motion score index and left ventricular ejection fraction to predict the combined endpoint (mortality and rehospitalization for heart failure) as a primary objective and the independent events of the combined endpoint as a secondary objective. Results: In 80.7% of patients, the wall motion score index was high despite having an ejection fraction >40%. No patient had an ejection fraction <55% with a normal index. After a follow-up of 30.5 months (24.2–49.5), both variables were predictors of the composite endpoint and all-cause mortality ( p<0.0001), although only the wall motion score index was a predictor of readmission for heart failure ( p=0.007). By multivariate analysis, a wall motion score index >1.8 proved to be the most powerful predictor of the composite endpoint (hazard ratio: 8.5; 95% confidence interval 3.7–18.8; p<0.0001). The superiority of the wall motion score index over ejection fraction was especially significant in patients with less myocardial damage (non-ST elevation myocardial infarction, or left ventricle ejection fraction >40%). Conclusions: Both variables provide important prognostic information after a myocardial infarction. Beyond the hyperacute phase, wall motion score index is a more powerful prognostic predictor, especially in subgroups with less myocardial damage.

scholarly journals The influence of afterload on left ventricular contractility: 2D-strain and dyssynchrony in stress echocardiography

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Karev ◽  
S Verbilo ◽  
E Malev ◽  
M Prokudina ◽  
A Suvorov
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Wall Motion ◽  
Wall Motion Score Index ◽  
Wall Motion Abnormalities ◽  
Response To Exercise ◽  
Score Index

Abstract Funding Acknowledgements Type of funding sources: None. Background Hypertensive response to exercise (HRE) has negative prognostic value but its impact on the  left ventricle (LV) contractility and on stress echocardiography (SE) results remains controversial. The global longitudinal strain (GLS) and LV dyssynchrony changes in response to afterload increase were shown even in patients with narrow QRS at rest, but not on exertion. Purpose We aimed to analyze the relation between the blood pressure (BP) during SE and LV GLS and dyssynchrony changes. Methods We performed exercise SE on treadmill in 96 patients without coronary artery stenosis (invasive or CT coronary angiography). Patients divided into two groups: HRE (n = 41) and normal response to exercise (NRE) (n = 55). We analyzed GLS and standard deviation of time between the onset of QRS and segmental longitudinal strain peaks (STE-TIME SD) using speckle tracking and 3d-ejection fraction (EF) at rest and on exertion. Results 2D-EF increase was higher in patients with NRE, but 3D-EF did not differ between groups. Wall motion abnormalities (WMA) on peak stress were detected more often in patients with HRE who had higher wall motion score index (WMSI). GLS on exertion and its increment were lower in HRE group (Fig. 1 - "Bull’s eye" diagrams of GLS at rest and on exertion in patient with NRE (upper panel) and HRE (lower panel)). Among dyssynchrony markers we revealed higher values of STE-TIME SD on exertion in HRE group (Table 1). Moreover the analysis showed positive correlations between BP level on exertion and peak GLS (r = 0.56, p &lt; 0.0001), GLS increase (r = 0.54, p &lt; 0.0001) and STE-TIME SD on exertion (r = 0.27, p &lt; 0.02) Conclusions HRE is associated with less increment in GLS and 2D-EF on exertion. Besides LV dyssynchrony signs can appear in response to exaggerated afterload increase even in patients with narrow QRS complexes. Patients with HRE more often show stress-induced WMA and have greater WMSI on exertion in absence of coronary artery lesions, thus HRE can alter the specificity of the test in transient ischemia detection. Table 1 HRE NRE p Δ-2D ejection fraction 5.0 (4.0; 7.0) 10.0 (8.0; 12.5) &lt;0.0000001 Δ-3D ejection fraction 8.25 (4.0; 8.25) 8.24 (8.15; 11.65) 0.09 Wall motion abnormalities on exertion 46.34% 1.8% &lt;0.00001 Wall motion score index 1.0 (1.0; 1.18) 1.0 (1.0; 1.0) 0.00013 GLS on exertion -21.0 (-22.0; -19.0) -24.0 (-26.5; -23.0) &lt;0.0000001 ΔGLS 0.0 (-1.0; 2.0) 4.0 (2.0; 6.0) &lt;0.0000001 STE-TIME SD-IMPOST 42.0 (35.0; 53.0) 35.0 (27.5; 45.0) 0.012 Left ventricle systolic function and dyssynchrony in two groups. Abstract Figure 1.

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