Early and late changes in left ventricular filling after acute myocardial infarction and the effect of infarct size

Pipilis, Athanase; Meyer, Theo E.; Ormerod, Oliver; Flather, Marcus; Sleight, Peter

doi:10.1016/0002-9149(92)90288-a

Cited by 31 publications

(19 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This cut off point has been shown to be consistent with restrictive hemodynamics and a powerfull independent predictor of unfavorable outcome after acute myocardial infarction[33,34]. The size of infarct zone has been shown to influence the diastolic filling pattern, with large infarcts exhibiting a restrictive filling pattern[35,36]. Therefore a short MDT, indicative of a restrictive filling pattern, might simply reflect an increasing infarct size and consequently a higher risk of left ventricular dilatation.WMSI and MDT can be simply determined by 2-D and Doppler echocardiographic examinations and if performed earlier after acute myocardial infarction, they can help to identify high risk patients for LVT development.…”

Section: Discussionmentioning

confidence: 95%

Risk factors for development of left ventricular thrombus after first acute anterior myocardial infarction-association with anticardiolipin antibodies

et al. 2010

View full text Add to dashboard Cite

BackgroundLeft ventricular thrombus(LVT] formation is a frequent complication in patients with acute anterior myocardial infarction(MI). LVT is associated with increased risk of embolism and higher mortality rates after acute MI. Anticardiolipin antibodies (ACA) are immunoglobulins that react with phospholipid-binding proteins interfering with the prothrombin activator complex. The effects of phospholipids on pathophysiology of cardiovascular thrombotic events are well known. In this study, we aimed to evaluate the importance of clinical and biochemical parameters including anticardiolipin antibodies on left ventricular thrombus formation after acute anterior MI.Methods and ResultsSeventy patients with a first anterior AMI were prospectively and consecutively enrolled. Patients with previous MI, autoimmune disease, collagen vascular disease and arterial or venous thrombosis history were excluded from this study. At the time of hospitalization, key demographic and clinical characteristics were collected including age, gender, ethanol intake and presence of traditional risk factors for atherosclerosis (hypertension, diabetes, smoking, hyperlipidemia, positive family history). Patients were evaluated for echocardiographic data, blood chemistry and ACA. Two-dimensional and Doppler echocardiographic examinations were performed in all patients within the first week and at 14 days after MI. LV thrombus was detected in 30 (42.8%) patients. ACA IgM levels were significantly higher in the patient group with LV thrombus than in the group without thrombus (12.44 ±4.12 vs. 7.69 ± 4.25 mpl, p = 0,01). ACA IgG levels were also found higher in the group with LV thrombus (24.2 ± 7.5 vs.17.98 ± 6.45 gpl, p = 0.02). Multivariate analyses revealed diabetes mellitus, higher WMSI, lower MDT and higher ACA IgM and higher ACA IgG levels as independent predictors of left ventricular thrombus formation.ConclusionsOur data demonstrate that beside the low ejection fraction, lower MDT and higher wall motion score index, modestly elevated ACA IgM and ACA IgG levels are associated with LV thrombus formation in patients with anterior MI.

show abstract

Section: Discussionmentioning

confidence: 95%

Risk factors for development of left ventricular thrombus after first acute anterior myocardial infarction-association with anticardiolipin antibodies

et al. 2010

View full text Add to dashboard Cite

show abstract

“…There are several potential explanations for this. Higher LV filling pressures are usually indicative of larger infarcts with more severe systolic dysfunction (1,(23)(24)(25)(26). In addition, LV pressure overload predisposes to ventricular remodeling, neurohormonal activation, and increased excitability (4,27,28), all of which would be expected to adversely affect the outcome.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive estimation of left ventricular filling pressure by e/e′ is a powerful predictor of survival after acute myocardial infarction

Hillis

Møller

Pellikka

et al. 2004

Journal of the American College of Cardiology

478

165

View full text Add to dashboard Cite

show abstract

“…2 On the other hand, the size of the infarct zone has been shown to influence the diastolic filling pattern, with the large infarcts exhibiting a "restrictive" filling pattern. 7,13 Therefore, a short DT, indicative of a restrictive filling pattern, might simply reflect an increasing infarct size and consequently a higher risk of LV dilation.…”

Section: Restrictive Filling Pattern and LV Remodelingmentioning

confidence: 99%

“…6 LV dilation may occur early after infarction, probably in part because of elevated filling pressure within the ventricle. 5,7,8 Doppler echocardiography has provided a rapid, feasible, and simple noninvasive method of assessing LV filling in various cardiac diseases 9 in which diastolic abnormalities have been observed, including AMI. 7,10 -12 Among the various diastolic variables, shortening of the deceleration time (DT) of the early filling wave, indicative of a "restrictive" filling pattern, has been found to correlate with infarct size 13 and to predict an adverse outcome of postinfarction patients.…”

mentioning

confidence: 99%

Doppler-Derived Mitral Deceleration Time

et al. 1999

View full text Add to dashboard Cite

Background-The relation between remodeling and left ventricular (LV) diastolic function has not yet been fullyinvestigated. The aim of this study was to determine whether early assessment of Doppler-derived mitral deceleration time (DT), a measure of LV compliance and filling, may predict progressive LV dilation after acute myocardial infarction (AMI). Methods and Results-Fifty-one patients (aged 61Ϯ11 years; 6 women) with anterior AMI successfully treated with direct coronary angioplasty underwent 2-dimensional and Doppler echocardiographic examinations within 24 hours of admission, at days 3, 7, and 30 and 6 months after the index infarction. Mitral flow velocities were obtained from the apical 4-chamber view with pulsed Doppler. End-diastolic volume index (EDVI) and end-systolic volume index (ESVI) were calculated with the Simpson's rule algorithm. Patients were divided according to the DT duration assessed at day 3 in 2 groups: group 1 (nϭ33) with DT Ͼ130 ms and group 2 (nϭ18) with DT Յ130 ms. Patency and restenosis rate at 6 months were similar between the 2 groups (94% group 1 vs 89% group 2; Pϭ0.52; 27% group 1 vs 33% group 2; Pϭ0.64, respectively). LV volume indexes were similar in both groups at baseline (EDVI: 71Ϯ3 group 1 vs 70Ϯ3 mL/m 2 group 2, Pϭ0.42; ESVI: 43Ϯ3 group 1 vs 48Ϯ3 mL/m 2 group 2, Pϭ0.13, respectively). From day 3 on, LV volume indexes progressively increased in group 2 and were significantly larger than those of group 1 at 6 months (LVEDVI 61Ϯ3 group 1 vs 104Ϯ6 mL/m 2 group 2, Pϭ0.00001; LVESVI 31Ϯ3 group 1 vs 73Ϯ6 mL/m 2 group 2, Pϭ0.00001, respectively). A significant inverse correlation was found between DT and changes in EDVI at 6 months (rϭϪ0.68; PϽ0.0000001). By stepwise multiple regression analysis among several clinical, demographic, angiographic, and echocardiographic variables, DT was the most powerful predictor of EDVI changes at 6 months (Pϭ0.02). Conclusions-These data suggest that early estimation (day 3) of Doppler-derived mitral DT provides a simple and accurate mean to predict late LV dilation after reperfused AMI. (Circulation. 1999;99:230-236.)

show abstract

Early and late changes in left ventricular filling after acute myocardial infarction and the effect of infarct size

Cited by 31 publications

References 20 publications

Risk factors for development of left ventricular thrombus after first acute anterior myocardial infarction-association with anticardiolipin antibodies

Risk factors for development of left ventricular thrombus after first acute anterior myocardial infarction-association with anticardiolipin antibodies

Noninvasive estimation of left ventricular filling pressure by e/e′ is a powerful predictor of survival after acute myocardial infarction

Doppler-Derived Mitral Deceleration Time

Contact Info

Product

Resources

About