Serial Doppler echocardiographic assessment of left and right ventricular performance after a first myocardial infarction

We sought to investigate the relation between left ventricular (LV) and rig ht ventricular (RV) function assessed with the Doppler-derived myocardial p erformance Index (MPI), to assess serial changes, and to investigate the pr ognostic value of biventricular assessment of cardiac function after a firs t myocardial Infarction (MI). To do so, serial Doppler echocardiography was performed in 77 consecutive patients with a first MI. Right ventricular MP I correlated significantly with LV MPI (r = 0.51, P <.0001). In patients wi th echocardiographic signs of RV MI, the RV MPI was significantly higher (0 .59 <plus/minus> 0.18 versus 0.44 +/- 0.19, P =.001), whereas no difference in LV MPI was seen (0.55 +/- 0.19 versus 0.56 +/- 0.13, P = not significan t). Right ventricular MPI showed a rapid normalization during follow-up, wh ereas LV MPI did not decrease. During follow-up, 23 patients died of cardia c causes or were readmitted because of worsening heart failure. Multivariat e Cox analysis Indicated LV MPI (relative risk 4.9 [95% CI 1.8-13.5], P =.0 02) and RV MPI (relative risk 3.8 [1.3-17.0], P =.01) to be predictors of c ardiac events. Thus the RV MPI is frequently abnormal after a first MT but normalizes rapidly on follow-up, and bi-ventricular assessment of cardiac f unction may improve the prognostic accuracy compared with LV assessment alo ne.