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Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
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Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Published on: October 14, 2016

Serial changes in regional diastolic left ventricular function after a first acute myocardial infraction

Mirza Husic1, Betina Nørager, Kenneth Egstrup

  • 1Department of Medical Research, Svendborg Hospital, Svendborg, Denmark.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|November 9, 2005
PubMed

Insights

Abnormal diastolic function after acute myocardial infarction (AMI) often resolves, especially in patients with viable heart muscle, suggesting a phenomenon known as diastolic stunning. Systolic function abnormalities, however, showed no significant change over six months.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Myocardial Infarction Research

Background:

  • Regional diastolic dysfunction can persist after acute myocardial infarction (AMI) even when systolic function appears normal.
  • The long-term implications and relationship to myocardial viability of post-AMI diastolic abnormalities remain unclear.

Purpose of the Study:

  • To investigate the temporal changes in regional diastolic and systolic function after AMI.
  • To determine the relationship between these functional changes and myocardial viability.

Main Methods:

  • 106 patients with a first AMI were assessed using echocardiography with color kinesis.
  • Regional left ventricular function (systole and diastole) was evaluated on days 1, and at 1, 3, and 6 months post-AMI.
  • The percentage of segments with abnormal wall motion was calculated for both systolic and diastolic function.

Main Results:

  • The area of diastolic wall-motion abnormality decreased significantly from baseline (38%) to 6 months (30%) post-AMI (P=.001).
  • No significant change was observed in systolic wall-motion abnormality over the same period (18% to 19%, P=.66).
  • Patients with myocardial viability showed a significant reduction in diastolic abnormalities, primarily in regions with only diastolic dysfunction, unlike those without viability.

Conclusions:

  • Abnormal diastolic wall motion is common after AMI and tends to resolve more than systolic abnormalities, particularly in patients with viable myocardium.
  • These findings suggest that post-AMI diastolic dysfunction may represent a transient phenomenon, termed 'diastolic stunning'.
  • Myocardial viability and N-terminal pro-brain natriuretic peptide levels are associated with the resolution of diastolic wall-motion abnormalities.

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