Diastolic dysfunction in acute myocardial infarction
Keywords:
acute myocardial infarction, diastolic dysfunction, heart failureAbstract
Introduction and objectives: Ischemic heart disease is among the first causes of disability and death in the world. The acute myocardial infarction alters considerably the myocardial relaxation. The echocardiogram is a useful, economic and harmless method to assess diastolic function in these patients; that is why the aim of the study was to characterize the behavior of this left ventricular function by means of an echocardiography. Methods: an observational descriptive study was carried out with 91 patients with myocardial infarction who were hospitalized at the Cardiology Ward of the Arnaldo Milian Castro Provincial University Hospital in Santa Clara during 2008. An echocardiogram was performed between the fifth and the seventh day of evolution, and the patterns of diastolic function were compared with other variables. Results: There was a prevalence of the male sex (74,7 %), the infarctions without ST segment elevation were more frequent (83,1 %) – which showed a bigger alteration of the relaxation, much more when the anterior and lateral walls of the left ventricle were involved. The presence of complications was linked to a bigger alteration of the relaxation, and the most associate ones were the contractile dysfunction and malignant arrhythmias. The decrease of the ejection fraction was linked to (p = 0,000) the prolongation of the relaxation. Conclusions: There was a prevalence of the infarction without ST segment elevation. It was more frequent in the male sex and it was associated with a higher level of alteration of the relaxation. The infarctions with anterior or lateral location, and those which caused complications, presented a higher level of this alteration. All patients with a reduced ejection fraction had relaxation disorders.
Downloads
References
1. Braunwald E. Braunwald. Tratado de Cardiología: Texto de medicina cardiovascular. 7ma ed. Madrid: Elsevier; 2006. p. 1364.
2. Cheitlin MD, Armstrong WF, AungemmaGP. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography-summary article: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 for the clinical Application of Echocardiography). J Am Coll Cardiol. 2003;42:954-70.
3. Anuario estadístico. La Habana: MINSAP; 2005.
4. Anuario estadístico. La Habana: MINSAP; 2006.
5. Anuario estadístico. La Habana: MINSAP; 2007.
6. Dokainish ZW, Lakkis N. Comparative accuracy of B-type natriuretic peptide and tissue Doppler echocardiography in the diagnosis of congestive heart failure. Am J Cardiol. 2004;93:1130-5.
7. Moller JE, Egstrup K, Poulsen S. Prognostic importance of systolic and diastolic function after acute myocardial infarction. Am Heart J. 2003;145:147-53.
8. González-Juanatey JR, Mazón P, Varela A. Insuficiencia cardíaca con función sistólica conservada (insuficiencia cardíaca diastólica). En: Manual de insuficiencia cardíaca. Madrid: Sociedad Española de Cardiología. 2003:91-110.
9. Aurigemma GP, Gaasch WH. Diastolic heart failure. N Engl J Med. 2004;351:1097-1105.
10. Wood MJ, Picard MH. Utility of echocardiography in the evaluation of individuals with cardiomyopathy. Heart. 2004;9:707-12.
11. Registro Nacional de Infarto Agudo de Miocardio de la Federación Argentina de Cardiología. Descripción metodológica, resultados preliminares y evaluación de la primera etapa de factibilidad. Rev Fed Arg Cardiol. 2004;33:127-31.
12. Lam CS, Ha JW. The mitral L wave. A marker of Pseudonormal filling and predictor of heart failure in patients with left ventricular hypertrophy. J Am Soc Echocardiogr. 2005;18:336-41.
13. Gutiérrez FP. Valoración cuantitativa de la disfunción diastólica con Doppler tisular. Arch Cardiol Mex. 2004;74 (Suppl 2):238-42.
14. Feiguembaum´s. Echocardiography. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 170-9.
15. Tschope C, Kasner M, Westermann D, Gaub R, Poller WC, Schultheiss HP. The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements. Eur Heart J. 2005;26:2277-84.
16. Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, et al. Clinical utility of Doppler echocardiograpry and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler catheterization study. Circulation. 2000;102:1788-94.
17. Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, et al. Guiderline update for the diagnosis and treatment of chronic heart failure: executive summary (update 2005). Eur Heart J. 2005;26:1115-40.
18. Hillis GS, Moller JE, Pellikka PA, Gersh BJ, Wright RS, Ommen SR, et al. Noninvasive estimation of left ventricular filling presure by E/e' is a powerful predictor of survival after acute myocardial infarction. J Am Coll Cardiol. 2004;43:360-7.
19. Barranco MA, Migliore RA, Adaniya ME, Luna P, Miramont G, Guerrero F, et al. Evaluación de la función diastólica en el infarto agudo del miocardio. Relación con el seguimiento alejado. Rev Argent Cardiol. 2007;75:360-6.
20. Møller JE. Ratio of left ventricular peak E wave velocity to flow propagation velocity assessed by color M-mode Doppler echocardiography in first myocardial infarction: prognostic and clinical implications. J Am Cardiol. 2000;35:363-70.
21. Møller JE. Prognostic importance of systolic and diastolic function after acute myocardial ainfarction. Am Heart J. 2003;145:147-53.
22. Bay M, Kirk V, Parner J, Hassager C, Nielsen H, Krogsgaard K, et al. Nt-proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function. Heart. 2003;89:150-4.
23. Møller JE, Pellikka PA, Hillis JS, Oh JK. Prognostic Importance of diastolic function and filling pressure in patients with acute myocardial infarction. Circulation. 2006;114:438-44.
24. Pritchett AM, Jacobsen SJ. Diastolic dysfunction and left atrial volume: A population based study. J Am Coll Cardiol. 2005;45:87-92.
25. García MJ. Diagnóstico y guía terapéutica de la insuficiencia cardíaca. Rev Esp Cardiol. 2004;56:396-406.
26. Tsang T, Barnes ME, Gersh BJ, Takemoto Y, Rosales G, Kent BR. Prediction of risk for first age-related cardiovascular events in an elderly population: The incremental value of echocardiography. J Am Cardiol. 2003;42:1199-1205.
27. Olson JJ, Young CE. Early mitral filling/diastolic mitral annular velocity ratio is not a reliable predictor of left ventricular filling pressure in the setting of several mitral regurgitation. J Am Soc Echocardiogr. 2006;19:83-7.
28. Pérez-Paredes M, Gonzálvez M, Ruiz Ros J, Giménez DM, Carnero A, Carrillo A, et al. Evaluación de las velocidades de pared de la aurícula izquierda mediante doppler pulsado tisular. Una nueva aproximación al estudio de la función auricular. Rev Esp Cardiol. 2004;57(11):1059-65.
29. Bruch C, Gruñe M, Muller J, Breithardt G, Wichter T. Usefulness of Tissue Doppler imagen for estimation of left ventricular filling pressures in patients with systolic and diastolic heart failure. Am J Cardiol. 2005;95:892-5.
30. Hunt S, ACC/AHA. 2005 Guiderline update for the diagnosis and management of chronic heart failure in the adult. J Am Coll Cardiol. 2005;46:1116-43.
31. Yip G. Clinical applications of strain rate imaging. J Am Soc Echocardiogr. 2003;16:1334-42.
32. Tabata T, Thomas JD, Klein AL. Pulmonary venous flor by Doppler echocardiography: revisited 12 years later. J Am Coll Cardiol. 2003;41:1243-50.
33. Peterson LR; Waggoner AD, Schechtman KB. Alterations in left ventricular structure and function in young healthy obese woman: assessmen by echocardiography and tissue Doppler imaging. J Am Coll Cardiol. 2004;43:1339-1404.
34. Cabell CH, Trichon BH, Velázquez EJ. Importante of echocardiography in patients with severe nonischemicheart failure: the cecond Prospective Randomized Amlodipine Survival Evaluation (PRAISE- 2) echocardiography study. Am Heart J. 2004;147:151-57.
35. Tsang TS, Barnes ME, Gersh BJ. Prediction of risk for first agerelated cardiovascular events in an elderly population: the incremental value of echocardiography. J Am Coll Cardiol. 2003;42:1199-1205.
36. Hashimoto I. Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue Doppler imagin. J Am Coll Cardiol. 2003;42:1574-83.
Downloads
Published
How to Cite
License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.