Atrioventricular plane displacement: does it predict in-hospital outcome after acute myocardial infarction?
1Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. wnammas@hotmail.com
Insights
Atrioventricular plane displacement below 10 mm effectively predicts major adverse cardiac events in ST-elevation myocardial infarction patients. This finding strongly correlates with ejection fraction below 40%.
Area of Science:
- Cardiology
- Echocardiography
- Acute Myocardial Infarction
Background:
- Left ventricular systolic function assessment is crucial in acute myocardial infarction.
- Atrioventricular plane displacement (AVPD) is a recognized echocardiographic parameter.
- Its predictive value for in-hospital outcomes in ST-elevation myocardial infarction (STEMI) requires further exploration.
Purpose of the Study:
- To evaluate the predictive capability of AVPD for in-hospital outcomes in patients with acute STEMI.
- To compare the predictive accuracy of AVPD with ejection fraction (EF) for major adverse cardiac events (MACE).
Main Methods:
- Prospective study of 93 STEMI patients.
- Trans-thoracic echocardiography for EF (Simpson's method) and mean AVPD measurement.
- AVPD cutoff <10 mm and EF cutoff <40% used for classification.
- In-hospital follow-up for MACE (death, heart failure, arrhythmias, angina, mechanical complications).
Main Results:
- MACE occurred in 72.7% of patients with AVPD <10 mm versus 8.5% with AVPD >=10 mm (p < 0.01).
- AVPD <10 mm demonstrated high sensitivity (72.7%) and specificity (91.5%) for predicting MACE.
- EF <40% showed similar predictive performance (sensitivity 72.7%, specificity 90.1%).
- A strong correlation was found between AVPD <10 mm and EF <40% (p < 0.01).
Conclusions:
- Left AVPD <10 mm is a reliable predictor of in-hospital MACE in STEMI patients.
- This echocardiographic parameter shows a strong correlation with reduced EF (<40%).
- AVPD offers valuable prognostic information for STEMI management.
Background And Objectives:
Atrioventricular plane displacement is a well-accepted method for assessment of left ventricular systolic function. We explored the ability of atrioventricular plane displacement to predict inhospital outcome in patients with acute ST-elevation myocardial infarction.
Materials And Methods:
Ninety three patients with acute ST-elevation myocardial infarction were prospectively included. Each patient underwent trans-thoracic echocardiography for measurement of the ejection fraction by the Simpson's method. Atrioventricular plane displacement was measured from the apical views, assessed in four different regions, namely, the septal, lateral, anterior and inferior ones, and the mean value was calculated. We used a cutoff value to classify patients into a group with atrioventricular plane displacement <10 mm and another with atrioventricular plane displacement > or=10 mm. Similarly, patients were classified into those with ejection fraction <40% and others with ejection fraction a 40%. All patients were followed-up during their in-hospital stay for the occurrence of major adverse cardiac events, namely, death, heart failure, complex ventricular arrhythmias, post-infarction angina, or mechanical complications.
Results:
During the follow-up period (3 +/- 1.5 days), major adverse cardiac events occurred in 16 (72.7%) patients with atrioventricular plane displacement <10 mm, and in 6(8.5%) patients with atrioventricular plane displacement > or =10 mm, p < 0.01. An atrioventricular plane displacement below 10 mm was able to predict the occurrence of major events with a sensitivity 72.7%, specificity 91.5%, negative predictive value (NPV) 91.5%, positive predictive value (PVP) 72.7%. Similarly, an ejection fraction below 40% predicted the occurrence of major events with a sensitivity 72.7%, specificity 90.1%, NPV 91.4%, PVP 69.6%. We found a strong correlation between an atrioventricular plane displacement < 10 mm, and an ejection fraction <40%, p < 0.01.
Conclusion:
Left atrioventricular plane displacement below 10 mm, can adequately predict the occurrence of in-hospital major adverse cardiac events after acute ST-elevation myocardial infarction, with a high correlation with ejection fraction below 40%.
