Value of echocardiography during hospital phase of acute myocardial infarction to predict left ventricular aneurysm

ABSTRACT

Left ventricular [LV] morphologic and functional changes were studied in 13 patients with acute myocardial infarction by Doppler echocardiography on admission [ADM], discharge [DIS], and after 6 weeks [6W]. Five patients developed LV aneurysm [group I] and 8 patients had no aneurysm [group II]. The mean wall motion index score [WMI] was 1.8 +/- 03 on ADM and 2.1 +/- 0.3 on DIS in group I versus 1.7 +/- 0.3 and 1.7 +/- 0.3 for group II [P <0.05]. The mean LV end-diastolic volume [LVEDV] was 209 +/- 68 ml on ADM and 229 +/- 66 ml on DIS in group I versus 167 +/- 26 ml and 183 +/- 26 ml for group II [P <0.05]. The mean LV end-systolic volume [LVESV] was 94 +/- 27 ml on ADM and 119 +/- 43 ml on DIS in group I versus 77 +/- 23 ml and 85 +/- 29 ml for group II [P <0.05]. The mean ejection fraction [EF] was 56 +/- 9% on ADM and 50 +/- 8% on DIS in group I versus 54 +/- 10% and 54 +/- 12% for group II. In group I the mean early to total mitral flow velocity ratio [E/Mi] was 7.5 +/- 3.3 on ADM, 4.9 +/- 1.4 on DIS, and 6.3 +/- 1.6 after 6W and the mean isovolumic relaxation time [IVR] was 100 +/- 25, 124 +/- 23, 98 +/- 18 msec, respectively. No significant changes in E/Mi or IVR were noticed in group II. In conclusion, early increase in WMI, LVEDV, LVESV, with EF drop during hospital phase of acute MI carries a higher risk for LV aneurysm formation