J Korean Soc Echocardiogr. 2001 Dec;9(2):116-124. Korean.
Published online Dec 31, 2001.
Copyright © 2001 Korean Society of Echocardiography
Original Article

Doppler Indexes of Pulmonary Venous Flow Predict Death after Acute Myocardial Infarction

Chee Whan No, Seung Jae Joo, Byung Joo Choi, Soo Hong Seo, Chae Hee Shin, Hyun Young Kim, Chan Ook Kim, Seong Man Kim, Tae Joon Cha and Jae Woo Lee
    • Department of Internal Medicine, Kosin Medical College, Busan, Korea.

Abstract

BACKGROUND

Restrictive left ventricular (LV) filling patterns after acute myocardial infarction (AMI) predict poor prognosis. Doppler indexes of LV inflow, especially peak velocity ratio of early versus late diastolic flow (E/A) and deceleration time, can predict heart failure or death. Doppler indexes of pulmonary venous flow are also used to diagnose restrictive LV filling, but their prognostic values after AMI are not known.

METHODS

Doppler echocardiographic examination were performed in patients with AMI (n=122) between 7 to 10 days after attack, and followed for 30 months. Death group included 9 deaths (7.4%) during follow-up. 18 age-matched patients (control group) were selected from 70 patients without death, heart failure or readmission. Doppler echocardiographic indexes of peak systolic velocity (SV), peak diastolic velocity (DV), and peak reverse flow velocity associated with atrial contraction (AR) of pulmonary venous flow were measured by transthoracic echocardiography.

RESULTS

Death group had lower SV (46.1±6.3 vs 57.0±14.7 cm/sec; p=0.059) and SV/DV ratio (1.26±0.50 vs 1.58±0.37; p=0.076). Death group had significantly more patients with SV/DV ratio less than 1.3 (67% vs 17%; p=0.026). AR was significantly different between death and control groups (29.7±7.8 vs 24.7±6.8 cm/sec; p=0.023). Death group had significantly more patients with AR greater than 25 (78% vs 33%; p=0.046).

CONCLUSION

SV/DV ratio and AR of pulmonary venous flow predicted death after AMI.

Keywords
Pulmonary venous flow; Acute myocardial infarction; Doppler echocardiography; Death


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