Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of leftReport as inadecuate




Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of left - Download this document for free, or read online. Document in PDF available to download.

Cardiovascular Ultrasound

, 9:17

First Online: 03 June 2011Received: 16 January 2011Accepted: 03 June 2011

Abstract

BackgroundLeft ventricular ejection fraction LVEF has been considered a major determinant of early outcome in acute myocardial infarction AMI. Myocardial performance index MPI has been associated to early evolution in AMI in a heterogeneous population, including non ST-elevation or previous AMI. Left atrial volume has been related with late evolution after AMI. We evaluated the independent role of clinical and echocardiographic variables including LVEF, MPI and left atrial volume in predicting early in-hospital congestive heart failure CHF specifically in patients with a first isolated ST-elevation AMI.

MethodsEchocardiography was performed within 30 hours of chest pain in 95 patients with a first ST-elevation AMI followed during the first week of hospitalization. Several clinical and echocardiographic variables were analyzed. CHF was defined as Killip class ≥ II. Multivariate regression analysis was used to select independent predictor of in-hospital CHF.

ResultsEarly in-hospital CHF occurred in 29 31% of patients. LVEF ≤ 0.45 was the single independent and highly significant predictor of early CHF among other clinical and echocardiographic variables odds ratio 17.0; 95% CI 4.1 - 70.8; p < 0.0001. MPI alone could not predict CHF in first ST-elevation AMI patients. Left atrial volume was not associated with early CHF in such patients.

ConclusionFor patients with first, isolated ST-elevation AMI, LVEF assessed by echocardiography still constitutes a strong and accurate independent predictor of early in-hospital CHF, superior to isolated MPI and left atrial volume in this particular subset of patients.

Keywordsacute myocardial infarction echocardiography myocardial performance index left atrial volume ejection fraction AbbreviationsAMIacute myocardial infarction

LVEFleft ventricular ejection fraction

MPImyocardial performance index

CHFcongestive heart failure

LAleft atrial

WMSIwall motion score index

DTdeceleration time

IVRTisovolumic relaxation time

IVCTisovolumic contraction time

ETejection time

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Author: Lilian P Souza - Orlando Campos - Clovis A Peres - Cristiano V Machado - Antonio C Carvalho

Source: https://link.springer.com/article/10.1186/1476-7120-9-17







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