ECHOCARDIOGRAPHIC EVALUATION OF LEFT VENTRICULAR FUNCTION AFTER ACUTE MYOCARDIAL INFARCTION
Keywords:
Acute Myocardial Infarction, Echocardiography, Left Ventricular Function, E/A ratio, Fractional fibre shorteningAbstract
Background: The study was taken up to evaluate the left ventricular systolic and diastolic function after acute myocardial infarction (AMI) in male patients. Method: A hospital based study was conducted at tertiary care centre in UP, India with 60 male healthy controls and 125 confirmed cases of AMI admitted to the coronary care unit who fulfilled the inclusion criteria. After a clinical examination/history taking, left ventricular (LV) functional parameters were assessed by echocardiography in M-mode. The data obtained was analyzed using Microsoft Excel2010 software. Results: The predominant sites of myocardial infarction (MI) were antero-septal MI (57.6%), with inferior wall MI (28%), and lateral wall MI (4.8%). Body mass index (BMI) was in overweight category in both study groups. A statistically significant difference was noted in haemodynamic parameters with lower values noted in AMI cases. Statistically significant differences with lower values in AMI cases were noted in Stroke volume (p<0.001), cardiac output (p<0.001), Ejection fraction (p<0.001) and Fractional fibre shortening (p<0.001) when compared with healthy subjects. A statistically significant decrease in E (p=0.015), increase in A (p<0.001) and decrease in E/A ratio (p=0.015) was noted in AMI cases when compared with healthy controls. Conclusion: The overall LV function was decreased among acute myocardial infarction patients. Echocardiographic assessment provides prognostic information which helps to stratify risks and initiate rationale therapeutic measures to reduce morbidity and mortality associated with it.
Pak J Physiol 2017;13(1):11–4
Downloads
References
2. Krishnan MN. Coronary heart disease and risk factors in India-on the brink of an epidemic? Indian Heart J 2012;64:364–7.
3. Nag T, Ghosh A. Prevalence of cardiovascular disease risk factors in a rural community in West Bengal, India. Int J Med Public Health 2015;5:259–64.
4. Ghosh A, Bose K, Chaudhuri ABD. Association of food patterns, central obesity measures and metabolic risk factors for coronary heart disease (CHD) in middle aged Bengalee Hindu men, Calcutta, India. Asia Pacific J Clin Nutr 2003;12(2):166–71.
5. Kutty RS, Jones N, Moorjani N. Mechanical Complications of Acute Myocardial Infarction. Cardiol Clin 2013;31(4):519–31.
6. Farah E, Fusco DR, Okumoto PR,Minicucci MF, Azevedo PS, Matsubara BB, et al. Impact of ventricular geometric pattern on cardiac remodeling after Myocardial Infarction. Arq Bras Cardiol 2013;100(6):518–23.
7. Vu DT, Martinez EC, Kofidis T. Myocardial restoration: is it the cell or the architecture or Both? Cardiol Res Pract 2012; (2012):1–11. doi:10.1155/2012/240497
8. Mateus PS, Dias CC, Betrencourt N, Adao L, Santos L, Sampaio F, et al. Left Ventricular Dysfunction after Acute Myocardial Infarction- The Impact of Cardiovascular Risk Factors. Rev Port Cardiol 2005;24(5):727–34.
9. White HD, Norris RM, Brown MA, Brandt PW, Whitlock RM, Wild CJ. Left ventricular end systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 1987;76(1):44–51.
10. Rahman HU, Khan SB, Noor L, Hadi A, Nawaz T, Shah ST, et al. Assessment of left ventricular systolic and diastolic function by Tissue Doppler Imaging after acute myocardial infarction. J Ayub Med Coll Abbottabad 2011;23(2):108–11.
11. Pozzoli M, Capomolla S, Opasich C, Reggiani R, Calsamiglia G, Cobelli F, et al. Left ventricular filling pattern and pulmonary wedge pressure are closely related in patients with recent anterior myocardial infarction and left ventricular dysfunction. Eur Heart J 1992;13:1067–73.
12. Sia YT, O’Meara E, Ducharme A. Role of echocardiography in Acute Myocardial Infarction. Curr Heart fail Rep 2008;5(4):189–96.
13. Cohen GI, Pietrolungo JF, Thomas JD, Klein AL. A practical guide to assessment of ventricular diastolic function using Doppler echocardiography. J Am Coll Cardiol 1996;27:1753–60.
14. Xie L, Wang Z. Correlation between echocardiographic left ventricular mass index and electrocardiographic variables used in left ventricular hypertrophy criteria in Chinese hypertensive patients. Hellenic J Cardiol 2010;51:391–401.
15. Pandey AK, Das A, Kumar A, Babu MS, Bhawani G, Himabindu Y. Myocardial performance in asymptomatic essential hypertension. Indian J Physiol Pharmacol 2011;55(2):110–8.
16. Garg B, Yadav N, Vardhan H, De AK. Asymptomatic Obese Hypertensives and Need of Routine Echocardiography for Left Ventricular Mass Assessment and Treatment. J Clin Diagn Res 2013;7:1599–603.
17. Bhardwaj R, Kandoria A, Sharma R. Myocardial infarction in young adults-risk factors and patterns of coronary artery involvement. Niger Med J. 2014;55(1):44–7.
18. Pfeffer MA, Braunwald E. Ventricular remodelling after myocardial infarction. Experimental observations and clinical implications. Circulation 1990;81:1161–72.
19. Freis ED, Schnaper HW, Johnson RL, Schreiner GE. haemodynamic alterations in acute myocardial infarction. I. Cardiac output, mean arterial pressure, total peripheral resistance, central and total blood volumes, venous pressure and average circulation time. J Clin Invest 1952;31(2):131–40.
20. Master AM, Jaffe HL, Dack S, Silver N. The course of Blood Pressure before, during and after coronary occlusion. Am Heart J 1943;26(1):92–107.
21. The Coronary Drug Project Research Group. Blood pressure in survivors of myocardial infarction. J Am Coll Cardiol 1984;4(6):1135–47.
22. Astrom M, Edhag O, Nyquist O, Vallin H. Haemodynamic effects of intravenous sotalol in acute myocardial infarction. Eur Heart J 1986;7:931–6.
23. Alam M, Witt N, Nordlander R, Samad BA. Detection of abnormal left ventricular function by Doppler tissue imaging in patients with a first myocardial infarction and showing normal function assessed by conventional echocardiography. Eur J Echocardiogr 2007;8(1):37–41.
24. Moller JE, Hillis GS, Oh JK, Reeder GS, Gersh BJ, Pellikka PA. Wall motion score index and ejection fraction for risk stratification after acute myocardial infarction. Am Heart J 2006;151:419–25.
25. Parfrey PS, Collingwood P, Foley RN, Bahrle A. Images in nephrology. Left ventricular disorders detected by M-mode echocardiography in chronic uraemia. Nephrol Dial Transplant 1996;11(7):1328–31.
26. Bogaert J, Bosmans H, Maes A, Suetens P, Marchal G, Rademakers FE. Remote myocardial dysfunction after acute anterior myocardial infarction: impact of left ventricular shape on regional function: a magnetic resonance myocardial tagging study. J Am Coll Cardiol 2000; 35(6):1525–34.
27. Hirose K, Reed JE, Rumberger JA. serial changes in left and right ventricular systolic and diastolic dynamics during the first year after an index left ventricular Q wave myocardial infarction. J Am Coll Cardiol 1995;25(5):1097–104.
28. Clerfond G, Biere L, Mateus V, Grall S, Willoteaux S, Prunier F, et al. End-systolic wall stress predicts post-discharge heart failure after acute Myocardial Infarction. Archi Cardiovasc Dis 2015;108(5):310–20.
29. Moller JE, Pellikka PA, Hillis GS, Oh JK. Prognostic Importance of Diastolic Function and Filling Pressure in Patients with Acute Myocardial Infarction. Circulation 2006;114(5):438–44.
30. Hadi A, Rahman HU, Nawaz T, Shah SFA, Shah ST, Khan I, et al. Evaluation of Left Ventricular Diastolic Function By Tissue Doppler Imaging after Acute Myocardial Infarction. Gomal J Med Sci 2011;9(2):148–51.
Downloads
Published
How to Cite
Issue
Section
License
Pakistan Journal of Physiology, Pak J Physiol, PJP is FREE for research and academic purposes. It can be freely downloaded and stored, printed, presented, cited and quoted with full reference of, and acknowledgement to the PJP.
