Serial assessment of left ventricular chamber stiffness after acute myocardial infarction

Left ventricular (LV) systolic function after acute myocardial infarction (AMI) has been the subject of detailed studies during the last decade, but diastolic phenomena during and after AMI are less well understood. Recently, it has been shown that early filling deceleration time accurately predicted LV chamber stiffness in an experimental model. To assess changes of LV stiffness after AMI, we studied 116 consecutive patients with 2-dimensional and Doppler echocardiographic examinations 1, 2, 3, 7, 21, and 42 days after AMI. Coronary angiography was performed in 101 patients. For the entire study group, deceleration time decreased nonsignificantly on day 2 and subsequently increased on days 3 (p = 0.001) and 7 (p = 0.036), returning toward initial values afterward. Deceleration time was shorter in large (peak creatine kinase level >1,000 U/L) versus small infarcts (p = 0.0008) and in patients with anterior versus inferior AMI (p = 0.02); there was no difference between patients with good and poor (< or = 45%) ejection fraction. These data indicate that increased LV stiffness can be detected 24 to 48 hours after AMI, but returns to normal within several days. Chamber stiffness is higher in large and anterior infarcts, but appears to be independent of LV systolic function.