Color M-mode and pulsed wave tissue Doppler echocardiography: Powerful predictors of cardiac events after first myocardial infarction

To assess the association between color M-mode How propagation velocity and the early diastolic mitral annular velocity (E-m) obtained with tissue Dop pler echocardiography and to assess the prognostic implications of the inde xes, echocardiography was performed on days 1 and 5, and 1 and 3 months aft er a first myocardial infarction in 67 consecutive patients. Flow propagati on velocity correlated well with E-m (r = 0.72, P < .0001). The ratio of pe ak E-wave velocity (E) to flow propagation velocity also correlated well wi th E/E-m (r = 0.87, P < .0001). The positive predictive value of E/FPV grea ter than or equal to1.5 to identify patients with Killip class greater than or equal to II was 90%, and the negative predictive value 92%. The corresp onding values for E/E-m greater than or equal to 10 were 70% and 90%. Cox p roportional hazards analysis identified E/flow propagation velocity greater than or equal to1.5 (relative risk, 12.4 [95% confidence interval, 4.1-37. 3]), E/E-m greater than or equal to 10 (relative risk, 11.5 [95% confidence interval, 3.8-34.7]), and Killip class greater than or equal to II (relati ve risk, 7.8 [95% confidence interval, 1.6-40.4]) to be predictors of the c omposite end point of cardiac death and readmission because of heart failur e. Thus flow propagation velocity and E-m. are closely related after myocar dial infarction and appear to have similar prognostic information.