SERIAL ASSESSMENT OF LEFT-VENTRICULAR CHAMBER STIFFNESS AFTER ACUTE MYOCARDIAL-INFARCTION

Left ventricular (LV) systolic function after acute myocardial infarct ion (AMI) has been the subject of detailed studies during the last dec ade, but diastolic phenomena during and after AMI are less well unders tood, Recently, it has been shown that early filling deceleration time accurately predicted LV chamber stiffness in an experimental model. T o assess changes of LV stiffness after AMI, we studied 116 consecutive patients with 2-dimensional and Doppler echocardiographic examination s 1, 2, 3, 7, 21, and 42 days after AMI. Coronary angiography was perf ormed in 101 patients, For the entire study group, deceleration time d ecreased nonsignificantly on day 2 and subsequently increased on days 3 (p = 0.001) and 7 (p = 0.036), returning toward initial values after ward, Deceleration time was shorter in large (peak creatine kinase lev el >1,000 U/L) versus small infarcts (p = 0.0008) and in patients with anterior versus inferior AMI (p = 0.02); there was no difference betw een patients with good and poor (less than or equal to 45%) ejection f raction, These data indicate that increased LV stiffness can be detect ed 24 to 48 hours after AMI, but returns to normal within several days . Chamber stiffness is higher in large and anterior infarcts, but appe ars to be independent of LV systolic function.