Prognostic significance of left ventricular diastolic dysfunction with preserved systolic function following acute myocardial infarction

ABSTRACT

The contribution of diastolic dysfunction in patients with preserved left ventricular [LV] systolic function to impaired functional status and cardiac mortality in myocardial infarction [MI] is unknown. Assessment of LV diastolic function was performed by Doppler analysis of the mitral and pulmonary venous flow and the propagation velocity of early mitral flow by color M-mode Doppler echocardiography in 150 consecutive patients at day 5-7 following their first acute MI. Patients were classified into four groups group A preserved LV systolic and diastolic function [n=59]; group B LV systolic dysfunction with preserved diastolic function [n=8]; group C LV diastolic dysfunction with preserved systolic function [n=49]; group D combined LV systolic and diastolic dysfunction [n=33]. The cardiac mortality rate at 6 months was significantly higher in groups C [12%] and D [36%] compared to A [2.5%] [p<0.01]. Multivariate regression analysis identified LV diastolic dysfunction [p=0.001], killip class >/= II [p=0.005], and age [0.007] as predictors of cardiac death or readmission due to heart failure. The presence of LV diastolic dysfunction is associated with increased morbidity and mortality following acute MI