Diastolic Dyssynchrony in Acute ST Segment Elevation Myocardial Infarction and Relationship with Functional Recovery of Left Ventricle
Journal of Cardiovascular Ultrasound
; : 208-214, 2016.
Article
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| WPRIM
| ID: wpr-35408
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ABSTRACT
BACKGROUND: Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known. METHODS: Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated. Diastolic delay was calculated from onset of QRS complex to peak of E wave in tissue Doppler image and presented as maximal temporal difference between peak early diastolic velocity of 6 basal segments of LV (TeDiff). Study patients were compared with demographically matched control group. RESULTS: Forty eight consecutive patients (55 ± 10 years, 88% male) and 24 controls (56 ± 6 years, 88% male) were included. TeDiff was higher in STEMI than in controls (35.9 ± 19.9 ms vs. 26.3 ± 6.8 ms, p = 0.025). Presence of DD was higher in STEMI than controls (58% vs. 33%, p = 0.046) according to calculated cut-off value (≥ 29 ms). There was no correlation between TeDiff and change in EDVI, ESVI, and LAVI at 6 months, however TeDiff and change in EF at 6 months was positively correlated (r = 0.328, p = 0.023). Patients with baseline DD experienced remodeling less frequently compared to patients without baseline DD (11% vs. 38%, p = 0.040) during follow-up. CONCLUSION: STEMI disrupts diastolic synchronicity of LV. However, DD during acute phase of STEMI is associated with better recovery of LV thereafter. This suggests that DD is associated with peri-infarct stunned myocardium that is salvaged with primary intervention as well as infarct size.
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Échocardiographie
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Incidence
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Études prospectives
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Études de suivi
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Sidération myocardique
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Ventricules cardiaques
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Infarctus du myocarde
Type d'étude:
Incidence_studies
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Observational_studies
/
Prognostic_studies
Limites du sujet:
Humans
langue:
En
Texte intégral:
Journal of Cardiovascular Ultrasound
Année:
2016
Type:
Article