Chest
Clinical InvestigationsCARDIOLOGYPrognostic Value of Global Myocardial Performance Indices in Acute Myocardial Infarction*: Comparison to Measures of Systolic and Diastolic Left Ventricular Function
Section snippets
Study Population
During the 1-year study period, 451 consecutive patients with documented AMI were admitted to the coronary care units of Sheba and Rabin Medical Centers. Myocardial infarction was diagnosed when at least two of the following criteria were present: chest pain lasting > 30 min; typical ECG changes; and elevated creatine kinase-MB fraction. Myocardial infarction location was determined using ECG criteria.11 Twelve patients died shortly after coronary care unit admission, before an
Results
At the end of the study period, 19 patients (4.7%) had died, 96 patients (23%) were in heart failure (Killip classification, ≥ 2), and 20 patients (4.8%) had experienced a recurrent myocardial infarction. A total of 103 patients (25%) had reached at least one end point and were compared as group B to the 314 patients (75%) without an end point (group A).
Discussion
The present study failed to demonstrate any incremental prognostic value of global MPIs compared to measures of systolic and diastolic LV function in a large, consecutive, and prospectively examined group of patients with AMI. Patients with poor and favorable outcomes differed significantly in most echocardiographic parameters of LV filling and ejection, and the discriminatory power of I/H was particularly high. However, only LVEF and EDT emerged as strong independent predictors of death, heart
ACKNOWLEDGMENT
We would like to thank Valentina Boyko, MSc, and Miriam Cohen, BSc, for their expert statistical assistance.
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2018, Egyptian Heart JournalCitation Excerpt :This correlation was also concluded by Ascione et al.13 who studied the predictive value of MPI in 94 patients presented with first acute MI and stated that MPI was significantly higher in patients with cardiac events and HF (0.65 ± 0.20 vs 0.43 ± 0.16, P = .0001). Though they differ in study group demographics and clinical characteristics, there are many other studies emphasizing the significant correlation between MPI and in-hospital HF following acute MI.9,14 The mean MPI in current study (0.88) was higher than previous studies (0.50–0.85).
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2017, Journal of the American Society of EchocardiographyCitation Excerpt :Worthy of note, the LVEF mortality curve after AMI exhibits a typical hyperbolic increasing with an upturn in mortality occurring at values < 40% (Figure 1).13 In 417 patients with AMI, an LVEF < 40% was an independent predictor of the combined endpoint of death, congestive HF, and recurrent AMI (odds ratio [OR] = 3.82; 95% CI, 2.15–6.87) at 30 days after AMI.11 In a large prospective cohort study,12 4,122 patients with AMI treated with primary percutaneous coronary intervention (PCI) underwent assessment of LVEF by invasive ventriculography, echocardiography, or radionuclide ventriculography before hospital discharge and were followed up for about 4 years.
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