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Prognosis evaluation of ecocardiographic diastolic dysfunction parameters in patients with myocardial infarction with ST elevation

Abstract:

Introduction: Left ventricular diastolic properties are altered in infarcted myocardium. Various methods have been employed for its evaluation. Doppler echocardiography has the advantage of being noninvasive, lower cost and with certain efficacy compared to other procedures. Objective: To evaluate echocardiographic parameters of diastolic dysfunction as a prognostic indicator in patients with acute myocardial infarction with ST-segment elevation (STEMI). Methods: An Analytical and prospective study was conducted. 30 patients admitted to the cardiology department of the Southern General Hospital of Maracaibo diagnosed with STEMI were studied. Transthoracic echocardiography was performed the first 72 hours and repeated after 6 months. According to the occurrence of events (angina / reinfarction, heart failure, malignant arrhythmia or death) patients were separated into two groups: group 1, patients without events and group 2 with events. Results: Patients with cardiovascular events had an E/e’ratio of 11.69 ± 5.7, in patients without events it was 7.39 ± 2.33 (p = 0.010). Furthermore significant differences in the S/D ratio of the flow of the pulmonary veins and E/Vp ratio were observed. Patients with E/e’ ≥8 had 25.91 times more risk of events with respect to those with E/e’<8 (OR 25.91, 95% CI 1.24 to 59.28; p = 0.03). Conclusions: Evaluation of diastolic dysfunction in patients with STEMI by transthoracic echocardiography, the E/e’ ratios, E/Vp and S/D all showed significant differences with control after 6 months. The relationship E/e’is an important pbkp_redictor of risk.