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KMID : 0390620150230030150
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Journal of Cardiovascular Ultrasound
2015 Volume.23 No. 3 p.150 ~ p.157
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Impaired Diastolic Recovery after Acute Myocardial Infarction as a Predictor of Adverse Events
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Yoon Hyun-Ju
Kim Kye-Hun
Kim Jong-Yoon
Cho Jae-Young
Yoon Nam-Sik
Park Hyung-Wook
Hong Young-Joon
Kim Ju-Han
Ahn Young-Keun
Jeong Myung-Ho
Cho Jeong-Gwan
Park Jong-Chun
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Abstract
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Background:To investigate the impact of left ventricular (LV) diastolic functional recovery on major adverse cardiac events (MACE) 6 months after acute myocardial infarction (AMI) in patients with preserved LV systolic function.
Methods:A total 463 patients with preserved LV systolic function at 6 months after an AMI were divided into two groups based on the extent of diastolic recovery assessed by echocardiography: group I (n = 241) showed improving diastolic function and group II (n = 222) did not. MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, and these events were compared with the patients’ characteristics at baseline.
Results:Compared with group I, the patients in group II were older and had a higher prevalence of hypertension and diabetes. Blood levels of hemoglobin and triglyceride were lower in group II, whereas the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and of high-sensitivity C-reactive protein were higher in this group than in group I. MACE were significantly more frequent in group II than in group I. Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictors of MACE.
Conclusion:Despite improvement in LV systolic function, LV diastolic function had not improved in 222 patients (47.9%) by the 6-month follow-up after the index AMI, and impaired diastolic functional recovery was found to be an independent predictor of MACE. Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.
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KEYWORD
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Myocardial infarction , Diastolic function , Prognosis
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