Related Experiment Videos
[Predictive value of various echocardiographic parameters of systolic and diastolic function in the development of
F Barillà1, R Santoro, S Abbolito
1II Cattedra di Cardiologia, Università degli Studi La Sapienza, Roma.
Insights
Echocardiography can predict congestive heart failure (CHF) risk after acute myocardial infarction (AMI). Key indicators include left ventricular (LV) diastolic filling (A/E ratio, A%) and systolic function (wall motion score-index).
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Acute myocardial infarction (AMI) can lead to congestive heart failure (CHF).
- Predictive markers for post-AMI CHF are crucial for patient management.
- Left ventricular (LV) systolic and diastolic function are key determinants of cardiac health.
Purpose of the Study:
- To assess the predictive value of LV systolic and diastolic function parameters for CHF development post-AMI.
- To identify specific echocardiographic measures that indicate increased CHF risk after myocardial infarction.
Main Methods:
- Studied 48 patients post-AMI using 2D and Doppler echocardiography (2D echo).
- Evaluated LV wall motion score-index, early diastolic filling (E), atrial systole filling (A), A/E ratio, and A% at acute phase and 6-month follow-up.
- Utilized multivariate analysis to identify predictive parameters for CHF development.
Main Results:
- 10 patients (21%) developed CHF within 6 months.
- CHF group showed depressed LV contractile function (wall motion score-index) and impaired diastolic filling (higher A/E ratio and A%).
- Multivariate analysis identified A/E ratio, A%, and wall motion score-index as significant predictors of CHF.
Conclusions:
- Combined 2D echo evaluation of LV systolic and diastolic function parameters improves CHF risk stratification post-AMI.
- Specific cut-points (A/E > 1.4, A% > 45%, score-index < 3.1) effectively predict CHF development.
- These echocardiographic parameters offer valuable insights for identifying high-risk patients after acute myocardial infarction.
Abstract:
To evaluate the predictive value of systolic and diastolic left ventricular (LV) function parameters, in the development of congestive heart failure (CHF) after acute myocardial infarction (AMI), 48 patients (mean age 56.2 +/- 10.4 years) were studied with two-dimensional and Doppler echocardiography (2D echo) in the acute phase (36 +/- 12 hours) and after 6 months of follow-up. The following parameters have been evaluated: LV wall motion score-index; peak velocity of early diastolic filling (E); peak velocity of filling during atrial systole (A); the ratio A/E; percent of LV filling contributed by atrial systole (A%). During follow-up 10 patients (Group B; 21%) developed symptoms and/or signs of CHF, while 38 patients (Group A; 79%) did not. In the patients who developed CHF 2D echo showed a depressed contractile function (mean value of wall motion score-index 3.08 +/- 0.45 versus 3.53 +/- 0.32 of Group A; p < 0.001) and a marked impairment of filling during atrial systole: A/E = 1.89 +/- 0.80 versus 1.07 +/- 0.35 (p < 0.001); A% = 52.2 +/- 9.9 versus 39.1 +/- 8.4 (p < 0.001). The multivariate analysis showed that the ratio A/E, A% and the wall motion score-index are the only variables that may predict the development of CHF. This capacity has been confirmed also considering the cut-point as conditional variables (A/E > 1.4; A% > 45%; score-index < 3.1). Our results demonstrate that a combined evaluation by 2D echo of systolic and diastolic LV function parameters allowed a better stratification of patients at risk of developing CHF after an AMI.