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 diastolic function evaluated by transmitral and pulmonary venous flow velocitie s obtained in the early phase of a first acute myocardial infarction i n relation to later development of congestive heart failure. Methods P ulsed Doppler echocardiography of transmitral and pulmonary venous flo w was assessed in 65 consecutive patients with a first myocardial infa rction within Ih of arrival in the coronary care unit. Results A univa riate regression analysis identified age, left ventricular ejection fr action less than or equal to 45%, mitral E deceleration time less than or equal to 130 ms, E/A ratio >1.5, peak pulmonary venous atrial flow velocity greater than or equal to 30 cm.s(-1) and a difference betwee n mitral and pulmonary venous atrial flow duration <0 ms as variables significantly related to the development of congestive heart failure. However, in a multivariate analysis only mitral E deceleration time le ss than or equal to 130 ms and age were significant independent variab les related to the development of congestive heart failure during the first week following a first acute myocardial infarction.Conclusion As sessment of left ventricular diastolic function complements measuremen ts of systolic function in the evaluation of cardiac function, and mit ral deceleration less than or equal to 130 ms best identifies patients at risk of development of congestive heart failure following acute my ocardial infarction.