Is mitral deceleration time can predict successful reperfusion?

Background Ventricular remodeling has emerged as one of the dominant factors that determine the long-term survival of post-infarction patients. It is also estimated that left ventricular enlargement after myocardial infarction increases the likelihood of an adverse outcome

Aim of the work: The aim of this study is to determine whether the early assessment of mitral deceleration time may predict left ventricular remodeling after successfully reperfused acute anterior myocardial infarction

Subjects and methods This study included 100 patients who were admitted to CCU with documented first anterior MI. Patients included in the study were in the proper time window for initiating reperfusion therapy, i.e. less than 12 hours from the beginning of symptoms. All patients included in the study were subjected to the following Complete History Taking, Thorough Clinical Examination; Electrocardiography, Laboratory Investigations and Echocardiography [Left Ventricular Dimensions, Systolic Function, Left Ventricular Wall Motion Score Index [WMSI] and Left Ventricular Diastolic Function Parameters

Conclusion: The most powerful predictor of LV remodeling, and LV dilation is related to the severity of impairment of LV filling. Patients with restrictive MV flow pattern [DT < 130 mSec.] had a higher level of peak serum level of CK enzyme, suggesting a larger infarction area. There was a strong correlation between DT and measures of LV systolic functions, as LVEDV, LVESV and EF. Also, there was a strong correlation between DT and E/A ratio

usefulness of carotid and femoral artery intimal-medial thickness as non-invasive predictors of coronary artery disease

Background: B-mode ultrasonography has shown that measurements of the intima-media thickness of carotid artery [CIMT] is useful in studying atherosclerosis, while study of femoral artery has received little attension

Objective: studying the predictive value of carotid intimal-medial thickness [CIMT] and femoral artery intimal medical thickness [FIMT] for coronary artery disease [CAD] and the relation to risk factors

Methods: Measurement of CIMT and FIMT was performed, utilizing B-mode ultrasonography, for 120 patients [84 males and 36 females] refered for coronary angiography. Biochemical studies included: lipid profile, microalbuminurea, fasting and postprandial blood sugar. Patients were classified into two groups: group l [18 patients] with normal coronary angiography [c. angio] and group 11[102 patients] with abnormal c. angio

Results: CIMT and FIMT were significantly increased in patients with CAD compared to those with normal angiography [P<0.01]. The CIMT and FIMT showed a significant correlation with the extent of CAD [P<0.03 and <0.01], the sensitivity, specificity, positive [ppv] and negative [npv] predictive values of CIMT for CAD were [73.5%, 60.6%, 92.5% and 30%] respectively. While that of FIMT were [88.2%, 88.8%, 97.8% and 57.5%] respectively. Using the univariante analysis: the following parameters were independent risk for CAD: age, DM, hypertension, dyslipidemia, CIMT and FIMT

Conclusion: The CIMT and FIMT can be considered as independent predictors of the presence and extent of CAD, and these non-invasive tests can be used in evaluation and screening for subclinical CAD in high risk population