[Evaluation of systolic and diastolic left ventricular function in acute myocardial infarction by aortic echogram]

A noninvasive method for the measurement of the cardiac output and diastolic ventricular function was evaluated by aortic echogram in a group of patients with acute myocardial infarction (AMI). The following parameters were employed: average of initial and late aortic cusp separation (ACS), left ventricular ejection time (EP) and amplitude of aortic posterior wall during ejection (AA). The following formula was used: cardiac output (CO) = (ACS x EP) x 100 + AA x HR. Diastolic ventricular function was evaluated by the left auricle emptying index (LAEI) described by Strunk et al. This last relationship X/OA where X is the movement of the aortic posterior wall (AP) at the first third of passive diastole, and OA is the total aortic movement during the passive diastole. All patients were followed by cardiac output measurements by thermodilution and pulmonary capillary pressure (PCP). Twenty measurements were made in fourteen subjects; for CO a good lineal correlation was found (r = 0.81). As for diastolic ventricular function, LAEI reached a value of 0.49 (+/- 0.23); normal value was 0.82 (p less than 0.01); it was significantly diminished showing the stiffness of the chamber. The utilization of aortic echogram and the analysis of movement of APW result in a non invasive reliable procedure that can be repeated to evaluate the hemodynamic situation in AMI.