Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of left ventricular function?

Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of left ventricular function?

Author Souza, Lilian P. Autor UNIFESP Google Scholar
Campos, Orlando Autor UNIFESP Google Scholar
Peres, Clovis A. Autor UNIFESP Google Scholar
Machado, Cristiano V. Autor UNIFESP Google Scholar
Carvalho, Antonio C. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Left ventricular ejection fraction (LVEF) has been considered a major determinant of early outcome in acute myocardial infarction (AMI). Myocardial performance index (MPI) has been associated to early evolution in AMI in a heterogeneous population, including non ST-elevation or previous AMI. Left atrial volume has been related with late evolution after AMI. We evaluated the independent role of clinical and echocardiographic variables including LVEF, MPI and left atrial volume in predicting early in-hospital congestive heart failure (CHF) specifically in patients with a first isolated ST-elevation AMI.Methods: Echocardiography was performed within 30 hours of chest pain in 95 patients with a first ST-elevation AMI followed during the first week of hospitalization. Several clinical and echocardiographic variables were analyzed. CHF was defined as Killip class >= II. Multivariate regression analysis was used to select independent predictor of in-hospital CHF.Results: Early in-hospital CHF occurred in 29 (31%) of patients. LVEF <= 0.45 was the single independent and highly significant predictor of early CHF among other clinical and echocardiographic variables (odds ratio 17.0; [ 95% CI 4.1 - 70.8]; p < 0.0001). MPI alone could not predict CHF in first ST-elevation AMI patients. Left atrial volume was not associated with early CHF in such patients.Conclusion: for patients with first, isolated ST-elevation AMI, LVEF assessed by echocardiography still constitutes a strong and accurate independent predictor of early in-hospital CHF, superior to isolated MPI and left atrial volume in this particular subset of patients.
Keywords acute myocardial infarction
echocardiography
myocardial performance index
left atrial volume
ejection fraction
Language English
Date 2011-06-03
Published in Cardiovascular Ultrasound. London: Biomed Central Ltd, v. 9, 6 p., 2011.
ISSN 1476-7120 (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent 6
Origin http://dx.doi.org/10.1186/1476-7120-9-17
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000291977900001
URI http://repositorio.unifesp.br/handle/11600/33795

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