Echocardiographic Indices of Increased Left Ventricular Filling Pressure and Dilation After Acute Myocardial Infarction

Hillis, Graham S.; Ujino, Keiji; Mulvagh, Sharon L.; Hagen, Mary E.; Oh, Jae K.

doi:10.1016/j.echo.2005.11.007

Cited by 58 publications

(46 citation statements)

References 28 publications

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“…Furthermore LA usually needs more time to adapt to high LV illing pressures than LV, as evidenced in patients with mitral valve regurgitation. In contrast to our indings there are some reports, where no association between LA volume and further LV remodeling was found post MI and that might probably be due to the relative short follow-up period [23].…”

Section: Discussioncontrasting

confidence: 99%

Left Atrial Remodeling is Associated with Left Ventricular Remodeling in Patients with Reperfused Acute Myocardial Infarction

Ce¹

2016

J Cardiol Cardiovasc Med

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Background: Left atrial volume (LAV) has been established as a sensitive marker of left ventricular (LV) diastolic function and as an independent predictor of mortality in patients with acute myocardial infarction (AMI). LA remodeling and its determinants in the setting of AMI have not been much studied. Methods:We studied 53 patients with anterior AMI and a relatively preserved LV systolic function, who underwent complete reperfusion and received guidelines guided antiremodeling drug management. LA and LV remodeling were assessed using 2D echocardiography at baseline and 6 months. LAV indexed for BSA (LAVi) was used as the index of LA size and further LA remodeling.Results: LAVi increased signifi cantly at 6 months compared to baseline [28.1 (23.0-34.5) vs 24.4 (19.5-31.6) ml/m2, p=0.002] following LV end diastolic-volume index change [56.8 (47.6-63.9) vs 49.5 (42.0-58.4) ml/ m2, p=0.0003]. Other standard LV diastolic function indices did not show any signifi cant change. Univariate analysis showed a strong positive correlation of LAVi change with BNP levels at discharge, LV mass index and LV volumes indices change, throughout the follow up period. Multivariate regression analysis revealed that BNP plasma levels was the most important independent predictor of LA remodeling (b-coef.=0.630, p=0.001).Conclusions: Despite current antiremodeling strategies in patients with AMI, LA remodeling is frequently asssociated with LV remodeling. Additionally LAVi change in the mid-term refl ects better than standard echocardiographic indices LV diastolic fi lling impairment.

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Section: Discussioncontrasting

confidence: 99%

Left Atrial Remodeling is Associated with Left Ventricular Remodeling in Patients with Reperfused Acute Myocardial Infarction

Ce¹

2016

J Cardiol Cardiovasc Med

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“…14,15,28,29 Hills et al have shown that E/E' predicts LV remodeling and prognosis in patients with acute myocardial infarction. 14,30 More recently, we demonstrated that E/E' predicted mortality of the non-valvular atrial fibrillation patients, irrespective of their S function. 15 …”

Section: Discussionmentioning

confidence: 86%

Elevated E/E' Predicts Prognosis in Congestive Heart Failure Patients With Preserved Systolic Function

Okura

Kubo

Asawa

et al. 2009

Circ J

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Background Although approximately 50% of heart failure patients are reported as heart failure with preserved left ventricular systolic function (HFPSF), echocardiographic prognostic predictors have not been well investigated. Recently, the tissue Doppler-derived index, the ratio of the early transmitral flow velocity and the early mitral annular velocity (E/E'), was reported as useful in predicting prognosis of patients with heart diseases. The purpose of this study was to investigate whether E/E' predicts prognosis in HFPSF. Methods and Results A total of 50 patients with HFPSF (ejection fraction >50%) were consecutively enrolled and studied. Echocardiographic examination was performed on admission and repeated after optimized medical therapy. Cardiac events were defined as death and unplanned hospitalization because of congestive heart failure. Cardiac event-free survival curves from patients with E/E' >15 and E/E' ≤15 at baseline did not differ. On the other hand, patients with E/E' >15 after medical therapy showed significantly lower cardiac event-free survival than patients with E/E' ≤15 (log-rank, P=0.005). By multivariate logistic regression analysis, E/E' >15 after medical therapy was the only independent predictor of cardiac events (P=0.037, risk ratio=6.1, 95% confidence interval: 1.12-33.3) in patients with HFPSF. Conclusions Elevated E/E' after optimized medical therapy may be useful in predicting cardiac events in patients with HFPSF. (Circ J 2009; 73: 86 -91)

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“…[11][12][13] However, no reports have been published about the functional paradox of systolic and diastolic function between patients with ABS and those with AMI. It appears that ABS (also called stress-induced cardiomyopathy) is related to an increase in demand of coronary flow or catecholamine, whereas AMI is related to a reduced supply of coronary flow.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Systolic and Diastolic Function in Patients With Apical Ballooning Syndrome Compared With Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction: A Functional Paradox

Park

Prasad

Rihal

et al. 2009

Mayo Clinic Proceedings

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OBJECTIVE:To compare left ventricular (LV) systolic and diastolic function in patients with apical ballooning syndrome (ABS) and those with acute myocardial infarction (AMI) using 2-dimensional Doppler echocardiography and strain rate imaging (SRI). PATIENTS AND METHODS:We prospectively enrolled patients with newly diagnosed AMI and ABS who had akinetic apical walls. Both 2-dimensional Doppler echocardiography and SRI were performed on hospital day 1 or within 24 hours of primary percutaneous coronary intervention. RESULTS:Twenty-four patients with AMI and 13 patients with ABS (mean ± SD age, 63±15 vs 73±12 years; P=.03) were prospectively enrolled in the study from October 3, 2005 through July 12, 2006.The mean ± SD LV end-diastolic volume was larger (58.1±9.1 vs 45.2±10.6 mL/m 2 ; P<.001) and the mean ± SD LV ejection fraction was lower (35%±6% vs 43%±9%; P=.006) in patients with ABS compared with patients with AMI. The early diastolic mitral annular velocity was similar (0.06±0.02 vs 0.06±0.02 m/s; P=.85) in both groups, but the ratio of early diastolic mitral valve inflow velocity to early diastolic mitral annulus velocity was higher in patients with AMI than in patients with ABS (16.3±6.9 vs 12.2±3.2; P=.05). The systolic strain rate was decreased at the apex in both groups (P=.98). Both the early diastolic strain rate of the apex (0.64±0.24 vs 0.48±0.30 s -1 ; P=.04) and the postsystolic shortening index of the apex (61%±15% vs 45%±23%; P=.006) were higher in the patients with ABS than in those with AMI. However, early diastolic SR was higher in the akinetic apical walls of patients with AMI with recovery than those with no recovery (0.64±0.35 vs 0.43±0.25 s -1 ; P=.04) and was similar between akinetic apical walls of patients with AMI with recovery and the akinetic apical walls of ABS.CONCLUSION: Compared with patients with AMI, those with ABS showed the functional paradox of worse initial LV systolic function with larger LV size but better LV diastolic function. The early systolic strain rate and postsystolic shortening were greater in patients with ABS than in those with AMI; hence, these measurements can be helpful in distinguishing ABS from AMI and in detecting myocardial viability.Mayo Clin Proc. 2009;84(6):514-521 ABS = apical ballooning syndrome; AMI = acute myocardial infarction; CAG = coronary angiography; E = early diastolic mitral valve inflow velocity; Ea = early diastolic mitral annulus velocity; E/Ea = ratio of early diastolic mitral valve inflow velocity to early diastolic mitral annulus velocity; ECG = electrocardiography; LV = left ventricular; LVEF = LV ejection fraction; PCI = percutaneous coronary intervention; SR = strain rate; SRI = SR imaging; STEMI = ST-segment elevation myocardial infarction; WMSI = wall motion score index © 2009 Mayo Foundation for Medical Education and ResearchT he clinical presentation of apical ballooning syndrome (ABS) mimics that of acute myocardial infarction (AMI). Both conditions are characterized by acute onset of chest pain, electrocardiographic (ECG) ...

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Echocardiographic Indices of Increased Left Ventricular Filling Pressure and Dilation After Acute Myocardial Infarction

Cited by 58 publications

References 28 publications

Left Atrial Remodeling is Associated with Left Ventricular Remodeling in Patients with Reperfused Acute Myocardial Infarction

Left Atrial Remodeling is Associated with Left Ventricular Remodeling in Patients with Reperfused Acute Myocardial Infarction

Elevated E/E' Predicts Prognosis in Congestive Heart Failure Patients With Preserved Systolic Function

Left Ventricular Systolic and Diastolic Function in Patients With Apical Ballooning Syndrome Compared With Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction: A Functional Paradox

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