E-WAVE DECELERATION TIME PREDICTS LEFT-VE NTRICULAR END-DIASTOLIC PRESSURE IN POSTINFARCTION PATIENTS WITH SYSTOLIC DYSFUNCTION

Objectives. Left ventricular end-diastolic pressure (LVEDP) is a usefu l parameter for the management of postinfarction patients. As the curr ent methods of estimating LVEDP are invasive, the existence of non-inv asive methods would be of great practical value. This study investigat es the relation between LVEDP and Doppler parameters such as E wave de celeration time (EDT) and E/A ratio, at one month following an acute m yocardial infarction. Methods. Eighty-nine patients with a first acute myocardial infarction treated with thrombolytic agents were studied. Doppler-echocardiography at 29 +/- 3 days and cardiac catheterization at 30 +/- 4 days postinfarction were performed. According to the eject ion fraction (EF), the patients were divided into group 1 (n = 17) wit h EF < 45%, and group 2 (n = 72) with EF > 45%. Results. Overall, the E/A ratio showed a weak correlation with LVEDP (r = 0.32; p=0.007), an d EDT did not correlate with LVEDP. When patients from group 2 were an alyzed, no correlation was found between LVEDP and either E/A or EDT. However, in patients from group I, LVEDP strongly correlated with both EDT (r = -0.83; p = 0.00001) and E/A (r = 0.70; p = 0.003). Moreover, the sensitivity and specificity of an EDT of less than 150 ms in pred icting a LVEDP > 20 mmHg was 100%. Conclusions. We conclude that at th e first month after a myocardial infarction EDT provides a noninvasive and useful parameter for estimating LVEDP in patients with systolic d ysfunction.