Related Experiment Video

Updated: Aug 7, 2026

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
14:35

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

Prognosis in myocardial infarction patients with heart failure and normal or mildly impaired systolic function

Christina Jarnert1, Magnus Edner, Hans E Persson

  • 1Department of Cardiology, Karolinska University Hospital, 176 71, Stockholm, Sweden. christina.jarnert@karolinska.se

International Journal of Cardiology
|July 25, 2006
PubMed

Insights

Diastolic dysfunction and natriuretic peptides improve prognosis prediction in acute myocardial infarction (AMI) patients with heart failure. Isovolumic relaxation time and N-terminal pro-ANP are key independent predictors of mortality and heart failure readmission.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Acute myocardial infarction (AMI) survivors with heart failure and preserved ejection fraction often have complex prognoses.
  • Identifying long-term prognostic factors is crucial for managing these patients.

Purpose of the Study:

  • To identify key factors predicting long-term prognosis in patients following an AMI who also experience heart failure but maintain normal or mildly reduced left ventricular systolic function.
  • To assess the prognostic value of diastolic function and natriuretic peptides in this specific patient cohort.

Main Methods:

  • A longitudinal study followed 71 AMI survivors with heart failure and echocardiographically determined ejection fraction >35-40% for 11 years.
  • Data collected included mortality, heart failure readmissions, new ischemic events, and pre-discharge echocardiographic and exercise test parameters.
  • N-terminal pro-ANP levels were measured to assess natriuretic peptide status.

Main Results:

  • Diastolic dysfunction was prevalent (84%) in this patient group.
  • Independent predictors of mortality included N-terminal pro-ANP, prolonged isovolumic relaxation time, and exercise-induced ST-depressions.
  • Heart failure readmission was associated with wall motion score, N-terminal pro-ANP, and prior heart failure history.
  • New ischemic events were linked to low Doppler A-wave flow velocity and male sex.

Conclusions:

  • Assessing diastolic function and natriuretic peptide levels (N-terminal pro-ANP) provides significant prognostic information in AMI patients with heart failure and preserved systolic function.
  • Isovolumic relaxation time emerged as an independent predictor of long-term mortality.
  • N-terminal pro-ANP is a significant predictor for both mortality and heart failure readmission.
Abstract

More Related Videos

Myocardial Infarction and Functional Outcome Assessment in Pigs12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...