Prognostic significance of left ventricular diastolic dysfunction with preserved systolic function following acute myocardial infarction

الملخص EN

Background : The contribution of diastolic dysfunction in patients with preserved left ventricular (LV) systolic function to impaired functional status and cardiac mortality in myocardial infarction (MI) is unknown.

Materials and Methods : Assessment of LV diastolic function was performed by Doppler analysis of the mitral and pulmonary venous flow and the propagation velocity of early mitral flow by color Mmode Doppler echocardiography in 150 consecutive patients at day 5-7 following their first acute MI.

Results : Patients were classified into four groups : group A : preserved LV systolic and diastolic function (n = 59) ; group B : LV systolic dysfunction with preserved diastolic function (n = 8) ; group C : LV diastolic dysfunction with preserved systolic function (n = 49) ; group D : combined LV systolic and diastolic dysfunction (n = 33).

The cardiac mortality rate at 6 months was significantly higher in groups C (12 %) and D (36 %) compared to A (2.5 %) (p < 0.01).

Multivariate regression analysis identified LV diastolic dysfunction (p = 0.001), killip class ≥ II (p = 0.005), and age (0.007) as predictors of cardiac death or readmission due to heart failure.

Conclusion : The presence of LV diastolic dysfunction is associated with increased morbidity and mortality following acute MI.