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 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.

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

Abstract 16032: Determinants of Exercise Capacity Assessed Using Combined Stress Echocardiography and Cardiopulmonary Exercise Testing in Patients Treated for Acute Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Krzysztof Smarz ◽  
Tomasz Jaxa-Chamiec ◽  
Beata Zaborska ◽  
Maciej Tysarowski ◽  
Andrzej Budaj
Keyword(s):  
Myocardial Infarction ◽  
Stress Echocardiography ◽  
Wall Motion ◽  
Cardiopulmonary Exercise Testing ◽  
Left Ventricular ◽  
Combined Stress ◽  
Wall Motion Score Index ◽  
Cardiopulmonary Exercise ◽  
Oxygen Difference ◽  
Score Index

Introduction: Exercise capacity (EC) after acute myocardial infarction (AMI) influences prognosis, but the causes of its reduction are complex and not sufficiently studied. Methods: We prospectively enrolled consecutive patients who underwent percutaneous coronary intervention for their first AMI without residual coronary stenosis and with left ventricular ejection fraction (LVEF) > 40% more than 4 weeks after the AMI. We performed combined stress echocardiography and cardiopulmonary exercise testing (CPET-SE) using a semi-supine cycle ergometer to determine predictors of EC (peak oxygen uptake [VO 2 ]). Results: Among 81 patients (70% male, mean age 58 ± 11 years), 40% suffered AMI with ST-segment elevation (STEMI), and 60% non-STEMI, LVEF was 57 ± 7%; wall motion score index, 1.18 (IQR 1.06 - 1.31); peak VO 2 , 19.5 ± 5.4 mL/kg/min. Multivariate analysis ( Table ) revealed that parameters at peak exercise: heart rate (β = 0.17, p < 0.001), stroke volume (β = 0.09, p < 0.001), and arteriovenous oxygen difference (β = 93.51, p < 0.001) were independently positively correlated with peak VO 2 , with arteriovenous oxygen difference being its strongest contributor. At rest, left ventricular systolic and diastolic function parameters and the extent of myocardial scarring (wall motion score index) did not predict EC (p > 0.05). Conclusions: In patients treated for AMI with normal/mildly reduced LVEF, EC is associated with peak peripheral oxygen extraction as well as peak heart rate and peak stroke volume. CPET-SE is a useful tool to evaluate decreased fitness in this group.

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.

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