Evaluation and prognostic significance of left ventricular diastolic function assessed by Doppler echocardiography in the early phase of a first acute myocardial infarction

AIM: To study the prognostic significance of left ventricular diastolicfunction evaluated by transmitral and pulmonary venous flowvelocities obtained in the early phase of a first acute myocardialinfarction in relation to later development of congestive heartfailure. METHODS: Pulsed Doppler echocardiography of transmitral and pulmonaryvenous flow was assessed in 65 consecutive patients with a firstmyocardial infarction within 1 h of arrival in the coronarycare unit. RESULTS: A univariate regression analysis identified age, left ventricularejection fraction 45%, mitral E deceleration time 130 ms, E/Aratio >1·5, peak pulmonary venous atrial flow velocity30 cm . s^–1 and a difference between mitral and pulmonaryvenous atrial flow duration >0 ms as variables significantlyrelated to the development of congestive heart failure. However,in a multivariate analysis only mitral E deceleration time 130ms and age were significant independent variables related tothe development of congestive heart failure during the firstweek following a first acute myocardial infarction. CONCLUSION: Assessment of left ventricular diastolic function complementsmeasurements of systolic function in the evaluation of cardiacfunction, and mitral deceleration 130 ms best identifies patientsat risk of development of congestive heart failure followingacute myocardial infarction.