Original scientific paper

Left ventricular diastolic function in acute myocardial infarction

Elnur Smajić orcid.org/0000-0003-0881-9443 ; University Clinical Centre Tuzla, Tuzla, Bosna and Herzegovina
Zumreta Kušljugić ; University Clinical Centre Tuzla, Tuzla, Bosna and Herzegovina
Fahir Baraković ; University Clinical Centre Tuzla, Tuzla, Bosna and Herzegovina
Daniela Lončar ; University Clinical Centre Tuzla, Tuzla, Bosna and Herzegovina
Larisa Dizdarević-Hudić ; University Clinical Centre Tuzla, Tuzla, Bosna and Herzegovina
Katarina Kovačević ; University Clinical Centre Tuzla, Tuzla, Bosna and Herzegovina
Đani Hadžović ; University Clinical Centre Tuzla, Tuzla, Bosna and Herzegovina

Abstract

Left ventricular (LV) diastolic function disorder is one of the first LV function disorders, which is detected before the regional disorder of contractility, ECG changes and chest pains, which significantly changes the prognosis of patients with acute coronary syndrome. The disorder of LV relaxation is often detected in patients with acute myocardial infarction (AMI), a disorder of LV stiffness in patients with anterior wall AMI. The most pronounced diastolic abnormality caused by myocardial ischemia is prolonged and delayed myocardial relaxation. Echocardiographic techniques allow the evaluation of diastolic filling of the both atria and ventricles.
The aim of this study was to determine the LV diastolic function in patients with AMI and compare the diastolic function variables in the groups of patients with anteroseptal and inferior wall AMI.
The prospective trial included 60 patients (37 men; mean age 59 ± 10) with first AMI who were divided into two groups according to the localization of ECG changes (anteroseptal vs. inferior wall). LV diastolic function variables were monitored that were analyzed by continuous (mitral flow) and pulsed color Doppler echocardiography technique (flow in the pulmonary veins and mitral ring motions).
The value ​​of velocity of early diastolic filling was not statistically significantly different in the both groups, but it was lower compared to the average value of the velocity of the early diastolic filling of LV in healthy persons. In the maximum velocity of systolic pulmonary venous flow, a statistically significant difference was recorded (p <0.05) among the groups of patiets. In the first group it was 0.48±0.10, while in the second group it was 0.57 ± 0.14. Maximum velocity of diastolic pulmonary venous flow in the first group was 0.37±0.09, while in the second group it was 0.43±0.16. The ratio of maximum velocity of systolic and diastolic pulmonary venous flow was slightly higher than in healthy individuals. In patients with AMI, diastolic dysfunction of the LV relaxation disorder type prevails (70%). In the examined group of patients with anteroseptal AMI, diastolic dysfunction of the relaxation disorder type prevails, that is, a statistically significant difference compared to the preserved diastolic function and diastolic dysfunction of the LV restriction disorder type (p <0.05) is recorded.
Finally, in case of anteroseptal and inferior wall AMI, the parameters of diastolic function are changed, that is, all three degrees of LV diastolic dysfunction are present. Diastolic dysfunction of myocardial relaxation disorder type prevails. In anteroseptal wall AMI, diastolic dysfunction of relaxation disorder type is present, that is, there is a good correlation with infarcated zone in relation to the inferior wall.

Keywords

acute myocardial infarction; echocardiography; diastolic function

Hrčak ID:

74632

URI

https://hrcak.srce.hr/74632

Publication date:

15.11.2011.

Article data in other languages: croatian

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