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[Changes in the left ventricular diastolic function in acute myocardial infarction]
1Országos Kardiológiai Intézet, Budapest.
Insights
Diastolic function changes are crucial in acute myocardial infarction (AMI) prognosis. Doppler echocardiography reveals worsening diastolic function often accompanies systolic decline, identifying high-risk patients.
Area of Science:
- Cardiology
- Echocardiography
- Myocardial Infarction Research
Background:
- Left ventricular systolic function changes in acute myocardial infarction (AMI) are well-documented.
- Diastolic function's role in AMI symptoms and patient prognosis is increasingly recognized.
- Non-invasive assessment methods are needed to evaluate diastolic function post-AMI.
Purpose of the Study:
- To non-invasively evaluate changes in left ventricular diastolic function following AMI.
- To determine the relationship between systolic and diastolic function in AMI patients.
- To identify potential indicators of prognosis using Doppler echocardiography.
Main Methods:
- Doppler echocardiography was used to examine 52 AMI patients within 48 hours and one week post-event.
- Systolic function was assessed via left ventricular outflow velocity.
- Diastolic function was characterized by mitral inflow parameters and patterns, categorizing into four types.
Main Results:
- Diastolic function improved in 18 patients and worsened in 9.
- Systolic function improved in 11 patients and decreased in 28.
- Worsening diastolic function consistently correlated with worsening systolic function; however, systolic decline occurred even with improved diastolic function in 8 cases.
Conclusions:
- Doppler echocardiography monitoring of AMI patients can reveal significant changes in both systolic and diastolic function.
- Worsening diastolic function is a marker of declining systolic function and potentially poorer prognosis.
- This non-invasive approach aids in identifying high-risk AMI patients requiring closer follow-up.
Abstract:
Changes of left ventricular systolic function in acute myocardial infarction are well known. However, diastolic function may also have a role for patients' symptoms and prognosis. The purpose of this study was to evaluate changes of diastolic function non-invazively and to delineate the relation between systolic and diastolic function. 52 patients with acute myocardial infarction were examined by Doppler echocardiography within the first 48 hours and one week later. Systolic function was defined by left ventricular outflow velocity measurements, diastolic function was characterized by mitral inflow parameters and patterns. Four types of mitral inflow were determined: normal pattern, patterns suggesting prolonged relaxation, pattern suggesting elevated filling pressure and "normalized" pattern. In the last situation the influence of prolonged relaxation and elevated filling pressure equalized each others effect producing a "normalized" inflow pattern. Diastolic function improved in 18 cases and impaired in 9 pts, systolic function improved only in 11 cases and decreased in 28 pts by the time of the second examination. Worsening of diastolic function was always accompanied by worsening of systolic function. Despite improving diastolic function, worsening in systolic function could be observed in 8 cases. Monitoring of patients with acute myocardial infarction by Doppler echocardiography offers a possibility to select high risk patients with worsening left ventricular function for further closer follow-up.