Validation of the wall motion score and myocardial performance indexes as novel techniques to assess cardiac function in mice after myocardial infarction

2007 ◽  
Vol 292 (2) ◽  
pp. H1187-H1192 ◽  
Author(s):  
Yan Zhang ◽  
Junya Takagawa ◽  
Richard E. Sievers ◽  
Muhammad F. Khan ◽  
Mohan N. Viswanathan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Wall Motion ◽  
Left Ventricular ◽  
Lv Function ◽  
Myocardial Performance ◽  
Ejection Time ◽  
Inflow Velocity ◽  
Mitral Inflow ◽  
Mitral Inflow Velocity ◽  
Deceleration Time

The aim of this study was to determine the feasibility and accuracy of wall motion score index (WMSI) and myocardial performance index (MPI) for measuring regional and global left ventricular (LV) function with use of high-resolution echocardiography after myocardial infarction (MI) in mice. In 48 mice, myocardial infarction was induced by ligation in the middle of the left anterior descending coronary artery. Echocardiography was performed under anesthesia at baseline and 1 mo after MI. WMSI was analyzed by a 16-segment model on short-axis views, and wall motion was scored as 1 for normal, 2 for hypokinetic, 3 for akinetic, 4 for dyskinetic, and 5 for aneurysmal. WMSI was calculated as the sum of scores divided by the total number of segments. MPI was calculated on the basis of isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT), and ejection time (ET): MPI = (IVCT + IVRT)/ET. We measured LV ejection fraction (LVEF), end-systolic and end-diastolic volumes (ESV and EDV), fractional shortening (FS), and infarct size (IS). LVEF at 4 wk after MI was reduced at 32.8 ± 9.0%. Linear correlation analyses showed that WMSI (1.6 ± 0.3) correlated with LVEF ( r = −0.84, P < 0.0005), FS ( r = −0.43, P = 0.003), and IS (34.3 ± 15.3%, r = 0.86, P < 0.0005). MPI (0.67 ± 0.09) correlated with LVEF ( r = −0.67, P < 0.0005) and IS ( r = 0.72, P < 0.0005). MPI also correlated with mitral inflow velocity ( r = −0.68, P < 0.0005) and deceleration time ( r = −0.42, P = 0.003). Stepwise regression analysis revealed that WMSI was independently associated with IS. IS, FS, mitral inflow velocity, and deceleration time were independent determinants of MPI. In conclusion, echocardiographic assessments of WMSI and MPI in mice are feasible and correlate strongly with two-dimensional measurement of LV function and IS. These novel parameters provide additional noninvasive assessment of regional and global LV function in mice after MI.

scholarly journals Predictors of Ischemic Cardiomyopathy in Patients with Acute Myocardial Infarction who Underwent Percutaneous Coronary Intervention

2020 ◽  
Vol 95 (3) ◽  
pp. 188-200
Author(s):  
Hye Sook Kim ◽  
Myung Ho Jeong ◽  
Hyun Ju Yoon ◽  
Yongcheol Kim ◽  
Seok-Joon Sohn ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ischemic Cardiomyopathy ◽  
Multivariate Logistic Regression Analysis ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Lv Function ◽  
Mitral Inflow ◽  
Diastolic Velocity ◽  
Mitral Inflow Velocity

Background/Aims: Many patients with acute myocardial infarction (AMI) suffer from heart failure due to progressive ischemic left ventricular (LV) remodeling. This study investigated the predictors of ischemic cardiomyopathy (ICMP) in patients with AMI who underwent successful percutaneous intervention.Methods: A total of 547 patients with AMI were divided into two groups: ICMP (n = 66, 67.1 ± 11.9 years, 78.8% males) and non-ICMP (n = 481, 62.5 ± 12.2 years, 70.1% males).Results: On echocardiography, the LVEF was significantly decreased (41.7 ± 10.5 vs. 55.4 ± 10.3%, <i>p</i> < 0.001) but the LV end-diastolic (54.1 ± 7.2 vs. 49.3 ± 5.3 mm, <i>p</i> < 0.001) and systolic (42.1 ± 8.0 vs. 33.5 ± 6.0 mm, <i>p</i> < 0.001) dimensions significantly increased in the ICMP group compared with the non-ICMP group. According to multivariate logistic regression analysis, LVEF < 50% (odds ratio [OR] 8.722, 95% confidence interval [CI] 2.986–25.478, <i>p</i> < 0.001), LV end-diastolic dimension > 55 mm (OR 4.511, 95% CI 1.561–13.038, <i>p</i> = 0.005), and ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e’) ≥ 15 (OR 3.270, 95% CI 1.168–9.155, <i>p</i> = 0.024) were independent predictors of ICMP development.Conclusions: The present study demonstrates that a larger LV size, lower LV function, and increased E/e’ (≥ 15) were independent predictors of ICMP. Therefore, the development of ICMP should be carefully monitored in AMI patients with these features.

Echocardiographic changes after myocardial infarction in a model of left ventricular diastolic dysfunction

1997 ◽  
Vol 273 (4) ◽  
pp. H2018-H2029 ◽  
Author(s):  
Gregory D. Pennock ◽  
Douglas D. Yun ◽  
Poonam G. Agarwal ◽  
Peter H. Spooner ◽  
Steven Goldman
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Coronary Artery Ligation ◽  
Sham Operation ◽  
Circumflex Artery ◽  
Inflow Velocity ◽  
Mitral Inflow ◽  
Mitral Inflow Velocity

To determine the early and late effects of myocardial infarction on left ventricular (LV) diastolic function in the rabbit postinfarction model, male New Zealand White rabbits were randomly assigned to ligation of the circumflex artery or sham operation. Serial echocardiographic and Doppler studies were performed on both groups of animals at baseline and 1 h and 3 wk after surgery ( n = 10 for each group) after verification of the reproducibility and repeatability of the measurements. At 1 h postinfarction, decreases in early mitral inflow velocity (E wave) and mitral inflow velocity with atrial contraction (A wave) and increases in the mean pulmonary venous systolic-to-diastolic ratio and A wave reversal velocities were observed, without changes in LV geometry. By 3 wk postinfarction, increases in the mitral E-to-A ratio (1.1 ± 0.3 vs. 2.9 ± 0.9, P < 0.001) and left atrial area (131 ± 23 vs. 510 ± 72 mm2, P < 0.001) and decreases in the pulmonary venous systolic-to-diastolic ratio (0.56 ± 0.20 vs. 0.79 ± 0.14, P = 0.008) were consistent with severe diastolic abnormalities (restricted physiology). The findings of this study demonstrate that coronary artery ligation in the rabbit provides a reproducible echocardiographic and Doppler model of LV diastolic dysfunction that is consistent with abnormalities found in humans with previous myocardial infarction, symptoms of heart failure, and preserved LV systolic function.

scholarly journals Echocardiographic assessment of left ventricular function in patients of acute myocardial infarction

2017 ◽  
Vol 4 (4) ◽  
pp. 926
Author(s):  
Anjali V. Shivpuje ◽  
Shrikant Page
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Wall Motion ◽  
Health Centre ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Lv Function ◽  
Regional Wall ◽  
Wall Motion Abnormalities ◽  
Echocardiographic Assessment

Background:2D Echo can evaluate LV anatomy, function and diagnose post AMI complications in early stages, thus help in management and determining the prognosis. The present study was undertaken to evaluate LV function in patient following AMI and also to find out the incidence of various echocardiographically detectable complications of following AMI.Methods: The present study was conducted on patients visiting our tertiary health centre during study duration. 50 patients were included in the study. Patients with prior history of acute myocardial infarction, pericarditis and early repolarisation syndrome, and primary myocardial disease diagnosed by serum enzyme levels were not included in the study. Patients were classified as per Killip classification and 2D echo study was performed in all patients.Results: Maximum incidence of AMI was found in 51-60 years of age, with male predominance (64%). Anterior wall AMI (58%) was more common. 94% of patients had wall motion abnormalities. Incidence of LV thrombus was found to be 24%. In present study, as the extent and severity of wall motion abnormalities increased, the incidence of LV thrombus also increased. Thus, 2DE study of LV regional wall motion can predict the incidence of LV thrombus.Conclusions: The echocardiographic assessment of LV function in patients of AMI is important as, it detects the regional wall motion abnormality, LVEF and also the complications like LV thrombus, pericardial effusion and LV aneurysm. These observations are of great value in the management of AMI.  

Left ventricular diastolic filling and systolic function of young and older trained and untrained men

2003 ◽  
Vol 95 (6) ◽  
pp. 2570-2575 ◽  
Author(s):  
James C. Baldi ◽  
Kendra McFarlane ◽  
Helen C. Oxenham ◽  
Gillian A. Whalley ◽  
Helen J. Walsh ◽  
...  
Keyword(s):  
Endurance Training ◽  
Young Men ◽  
Older Men ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Diastolic Filling ◽  
Inflow Velocity ◽  
Mitral Inflow ◽  
Mitral Annular Velocity ◽  
Mitral Inflow Velocity

Aging is associated with impaired early diastolic filling; however, the effect of endurance training on resting diastolic function in older subjects is unclear. Heart rate and ventricular loading conditions affect mitral inflow velocities measured by Doppler echocardiography; therefore, tissue Doppler imaging of mitral annular velocity, which is relatively preload independent, was combined with mitral inflow velocity and maximal oxygen consumption (V̇o2 max) in young (20-35 yr) and older (60-80 yr) trained and untrained men to determine whether endurance training is associated with an attenuation of age-associated changes in diastolic filling. As expected, V̇o2 max was higher in trained men ( P < 0.01) and lower in older men ( P < 0.01). Peak early mitral inflow velocity (E) and early-to-late mitral inflow velocity ratios were lower in older vs. young men ( P < 0.01); however, there was no training effect ( P > 0.05). Peak early mitral annular velocity (E′) was higher and peak late mitral annular velocity (A′) was lower in young vs. older men ( P < 0.01). A significant interaction effect was found for A′, E′/A′, and peak systolic mitral annular velocity (S′). Training was associated with lower A′ in young and higher A′ in older men. S′ was greater in trained vs. untrained older men ( P < 0.05), but it was similar in trained and untrained young men. These findings suggest that early diastolic filling is not affected by training in older men, and the effect of training on A′ and S′ is different in young and older men.

scholarly journals 25 Mitral inflow velocity encoded imaging by CMR for the assessment of left ventricular haemodynamics

2019 ◽  
Author(s):  
Nithin Balasubramanian ◽  
Natasha Barker ◽  
Benjamin Fidock ◽  
Alistair W Macdonald ◽  
David Capener ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Inflow Velocity ◽  
Mitral Inflow ◽  
Mitral Inflow Velocity

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.

Abstract 2664: Clinical Outcome and Left Ventricular Contractile Function After Distal Protection in Primary Percutaneous Coronary Intervention The Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction (DEDICATION) Trial

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Klaus F Kofoed ◽  
Henning Kelbæk ◽  
Leif Thuesen ◽  
Steen H Poulsen ◽  
Christian Hassager ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Clinical Outcome ◽  
Wall Motion ◽  
Contractile Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Lv Function ◽  
Percutaneous Coronary ◽  
Distal Protection

Objective Embolization of material from an infarct-related lesion during percutaneous coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on clinical outcome and myocardial function. Methods and results Patients with STEMI were randomly referred within 12 hours for PCI with (n = 312) or without distal protection (n = 314). Left ventricular (LV) contractile function was assessed with echocardiography 8 month after PCI. Global LV myocardial wall motion index (WMI) was calculated as the average wall motion score of all myocardial segments. Major adverse cardiac and cerebral events (MACCE) 8 months after PCI was 7.1 % after distal protection and 5.7 % after conventional treatment (p = 0.17). WMI improved by 4.1% at 8 months in patients treated with distal protection compared to patients receiving conventional PCI (p<0.01). In myocardium subtended by culprit coronary vessels treated with distal protection regional LV function was 9 –11% higher than myocardial regions treated conventionally (p<0.02). Conclusion Routine use of distal protection during primary PCI is associated with a significant improvement in LV contractile function, with no detectable impact on intermediate term clinical outcome.

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