Left Ventricular Systolic and Diastolic Functions after Cardiac Rehabilitation in Successfully Revascularized Patients with Acute Myocardial Infarction

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M I A S Rashed ◽  
I M Bastawy ◽  
H M Khorshid ◽  
A A Sharafeldin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Diastolic Function ◽  
Speckle Tracking ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Before And After ◽  
2D Speckle Tracking ◽  
Diastolic Functions

Abstract Background Coronary artery disease (CAD) is a widely prevalent disease with many adverse sequelae. As survival after myocardial infarction or coronary revascularization has improved, cardiac rehabilitation and secondary prevention services have become more important. Advances in ultrasound such as Doppler imaging, strain or strain rate imaging provide comprehensive information on left ventricle (LV) myocardial contractility. Objective to evaluate the possible early effect of intensive supervised Cardiac rehabilitation on the LV systolic and diastolic functions in patients with acute myocardial infarction (AMI) who had been successfully revascularized by primary percutaneous coronary intervention (PCI) using two dimensional (2D) speckle tracking and doppler imaging. Patients and Methods thirty patients with AMI and successfully revascularized by primary PCI were enrolled in the study. LV global longitudinal strain (LVGLS) analysis was performed using 2D speckle tracking echocardiography before and after Cardiac rehabilitation. LV ejection fraction (EF) was measured using the modified Simpson’s method. Pulsed-wave Doppler at the tip of mitral valve leaflets was also done allowing us to measure the early (E) and late (A) diastolic filling velocities, E/A ratio. The LV tissue velocity was measured by TDI of the lateral mitral annulus (e’) and E/e’ was calculated and LV diastolic dysfunction (DD) grade was estimated. Results There was significant improvement in LVEF measurements before and after Cardiac rehabilitation (47.50 ± 6.42 before vs. 52.17 ± 6.64 after; p = 0.000).The improvement in 2D speckle tracking LVGLS after Cardiac rehabilitation was statistically significant (p = 0.000). the diastolic function as assessed by TDI after a 3-month program of exercise-based cardiac rehabilitation has improved with decrease in the number of patients with DD grade I and increase in the number of normal diastolic function with p-value P < 0.01(highly significant). Conclusion cardiac rehabilitation has beneficial effects on LVGLS, LVEF as well as diastolic function after AMI and successful revascularization.

scholarly journals Effect of Cardiac Rehabilitation on Left Ventricular Diastolic Function in Patients with Acute Myocardial Infarction

2021 ◽  
Vol 10 (10) ◽  
pp. 2088
Author(s):  
Jae-Hwan Lee ◽  
Jungai Kim ◽  
Byung Joo Sun ◽  
Sung Ju Jee ◽  
Jae-Hyeong Park
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Volume Index ◽  
Prognostic Impact ◽  
Echocardiographic Parameters

Cardiac rehabilitation (CR) improves symptoms and survival in patients with acute myocardial infarction (AMI). We studied the change of diastolic function and its prognostic impact after CR. After reviewing all consecutive AMI patients from January 2012 to October 2015, we analyzed 405 patients (mean, 63.7 ± 11.7 years; 300 males) with baseline and follow-up echocardiographic examinations. We divided them into three groups according to their CR sessions: No-CR group (n = 225), insufficient-CR group (CR < 6 sessions, n = 117) and CR group (CR ≥ 6 sessions, n = 63). We compared echocardiographic parameters of diastolic dysfunction including E/e’ ratio > 14, septal e’ velocity < 7 cm/s, left atrial volume index (LAVI) > 34 mL/m2, and maximal TR velocity > 2.8 m/s. At baseline, there were no significant differences in all echocardiographic parameters among the three groups. At follow-up echocardiographic examination, mitral annular e’ and a’ velocities were higher in the CR group (p = 0.024, and p = 0.009, respectively), and mitral E/e’ ratio was significantly lower (p = 0.009) in the CR group. The total number of echocardiographic parameters of diastolic dysfunction at the baseline echocardiography was similar (1.29 vs. 1.41 vs. 1.52, p = 0.358). However, the CR group showed the lowest number of diastolic parameters at the follow-up echocardiography (1.05 vs. 1.32 vs. 1.50, p = 0.017). There was a significant difference between the No-CR group and CR group (p = 0.021). The presence of CR was a significant determinant of major adverse cardiovascular events in the univariate analysis (HR = 0.606, p = 0.049). However, the significance disappeared in the multivariate analysis (HR = 0.738, p = 0.249). In conclusion, the CR was significantly associated with favorable diastolic function, with the highest mitral e’ and a’ velocity, and the lowest mitral E/e’ ratio and total number of echocardiographic parameters of diastolic dysfunction at the follow-up echocardiographic examinations in AMI patients.

Management of Ventricular Fibrillation during Acute Myocardial Infarction

1984 ◽  
Vol 23 (04) ◽  
pp. 209-213
Author(s):  
B. J. Northover
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Fibrillation ◽  
Coronary Care Unit ◽  
Patient Survival ◽  
Left Ventricular ◽  
Ventricular Failure ◽  
Before And After ◽  
Coronary Care ◽  
The Creation

SummaryAnalysis of electrocardiograms tape-recorded from patients admitted to hospital with acute myocardial infarction revealed that the pattern of ventricular extrasystolic activity was not significantly different among those who subsequently developed ventricular fibrillation and those who did not. Episodes of ventricular fibrillation occurred predominantly within 4 hours from the start of infarction. Patients were 3 times less likely to survive an episode of ventricular fibrillation if they also had left ventricular failure than if this feature was absent. Management of episodes of ventricular fibrillation was compared in patients before and after the creation of a specially staffed and equipped coronary care unit. The success of electric shock as a treatment for ventricular fibrillation was similar before and after the creation of the coronary care unit. An attempt was made to determine which features in the management of ventricular fibrillation in this and in previously published series were associated with patient survival.

Predictors of Left Ventricular Remodeling Post Acute Myocardial Infarction. Protocol for a Clinical Study

2019 ◽  
Vol 4 (3) ◽  
pp. 120-123
Author(s):  
Ioana Cîrneală ◽  
Diana Opincariu ◽  
István Kovács ◽  
Monica Chițu ◽  
Imre Benedek
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Speckle Tracking ◽  
Ventricular Remodeling ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Serum Biomarkers ◽  
Remodeling Index

Abstract Heart failure is a clinical syndrome that appears as a consequence of a structural disease, and the most common cause of left ventricular systolic dysfunction results from myocardial ischemia. Cardiac remodeling and neuroendocrine activation are the major compensatory mechanisms in heart failure. The main objective of the study is to identify the association between serum biomarkers illustrating the extent of myocardial necrosis (highly sensitive troponin as-says), left ventricular dysfunction (NT-proBNP), and systemic inflammatory response (illustrated via serum levels of hsCRP and interleukins) during the acute phase of a myocardial infarction, and the left ventricular remodeling process at 6 months following the acute event, quantified via speckle tracking echocardiography. The study will include 400 patients diagnosed with acute myocardial infarction without signs and symptoms of heart failure at the time of enrollment that will undergo a complex clinical examination and speckle tracking echocardiography. Serum samples from the peripheral blood will be collected in order to determine the inflammatory serum biomarkers. After 6 months, patients will be divided into 2 groups according to the development of ventricular remodeling, quantified by speckle tracking echocardiography: group 1 will consist of patients with a remodeling index lower than 15%, and group 2 will consist of patients with a remodeling index higher than 15%. All clinical and imaging data obtained at the baseline will be compared between these two groups in order to determine the features associated with a higher risk of deleterious ventricular remodeling and heart failure.

Effect of overweight and obesity on the left ventricular systolic and diastolic functions in patients with acute myocardial infarction

2012 ◽  
Vol 35 (4) ◽  
pp. 229 ◽  
Author(s):  
Fatih Poyraz ◽  
Murat Turfan ◽  
Sinan A. Kocaman ◽  
Huseyin U. Yazici ◽  
Nihat Sen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Function ◽  
Systolic Function ◽  
Study Groups ◽  
Left Ventricular ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Weight Group ◽  
Normal Weight Group ◽  
Diastolic Functions

Purpose: The purpose of this study was to evaluate whether a association exits among overweight and obesity and left ventricular systolic and diastolic functions in patients admitted with first ST-elevation myocardial infarction (STEMI). Methods: The present study was performed on 451 consecutive patients diagnosed with first STEMI (376 men, 75 women; mean age 56.1±10.8 years). The patients were classified into three groups based on their body mass index (BMI) as normal weight (BMI < 25 kg/m2), overweight (BMI: 25-29.9 kg/m2) and obese (BMI > 30 kg/m2). Echocardiographic features were evaluated and compared among the three groups. Results: Mitral annulus E velocities were higher in obese individuals than normal weight group (p < 0.01). In contrast, mitral A velocities were lower (p =0.03); consequently, E\A and E'\A' ratios were lower (both p =0.01) in the obese group with respect to normal weight group. When the correction of entire variations existing among the groups were performed using multivariate linear regressions analyses, it turned out that BMI was independently associated with E/A (β= -0.19, p =0.044) and with E'/A' (β= -0.016, p=0.021). Ejection fraction, wall motion score index and myocardial S velocities were comparable among the study groups (p > 0.05). Conclusion: These results suggest that while obesity has no adverse effect on the left ventricular systolic function, it has unfavorable consequences on the left ventricular diastolic function in the patients with first STEMI. In contrast, no unfavorable effects of overweight on the left ventricular systolic and diastolic function were detected.

scholarly journals Assessment of left ventricular systolic and diastolic functions in severely malnourished children

2019 ◽  
Vol 67 (1) ◽  
Author(s):  
Gihan M. Bebars ◽  
Hany T. Askalany
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Nutritional Rehabilitation ◽  
Malnourished Children ◽  
Grade Ii ◽  
Diastolic Functions

Abstract Background Malnourished children endure many changes in body composition and lose heart and skeletal muscle mass. Diastolic dysfunction is one of the major causes of heart failure with preserved ejection fraction. Aim To assess left ventricular systolic and diastolic functions in children with severe acute malnutrition using tissue Doppler imaging technique and to evaluate the effect of nutritional rehabilitation. Patients and Methods A follow-up case-control study conducted on 60 severely malnourished children (WHZ < -3SD) and 120 age and sex-matched healthy children as a control group. Tissue Doppler imaging (TDI) was done for all included malnourished children at admission and for control to measure left ventricular systolic and diastolic functions. Nutritional rehabilitation was done according to WHO protocol and tissue doppler was repeated after rehabilitation when (WHZ > -2SD) to detect any changes in systolic or diastolic functions. Results Systolic function was normal in malnourished children and control. Grade I diastolic dysfunction was detected in 40% and grade II in 30% of severely malnourished children in comparison to 100% normal diastolic function in control group. No correlations between diastolic dysfunction and either anthropometric measurements, electrolyte disturbances or Hb% in malnourished children before nutritional rehabilitation. Mortality from sepsis with associated ventricular dysfunction grade II documented in 3.3% of malnourished children. After nutritional rehabilitation diastolic function improved significantly as 65.6% of children attained normal diastolic function, 31% grade1 and 3.4% grade II. Positive correlations between diastolic function and WAZ, HAZ, WHZ and MUAC after rehabilitation. Conclusion Severe acute malnutrition affects diastolic function in children which is reversible in most of these cases with rehabilitation. TDI is an easy and practical method for detection and follow-up of ventricular function in malnourished children.

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