We studied 536 patients with acute myocardial infarction and echocardiographic assessment of left ventricular systolic and diastolic function and measurement of right ventricular systolic pressure. On multivariable an...We studied 536 patients with acute myocardial infarction and echocardiographic assessment of left ventricular systolic and diastolic function and measurement of right ventricular systolic pressure. On multivariable analysis, the grade of diastolic function, mitral regurgitation severity, age, and wall motion score index were independent predictors of right ventricular systolic pressure, and an increase in right ventricular systolic pressure was independently predictive of mortality(hazard ratio 1.22 per 10 mm Hg, p< 0.0001), after adjustment for conventional risk factors and left ventricular function.展开更多
In addition to clinical risk markers, indices of left ventricular(LV) systolic function are valuable prognostic markers after acute myocardial infarction(MI). Previous studies have also suggested that LV diastolic fun...In addition to clinical risk markers, indices of left ventricular(LV) systolic function are valuable prognostic markers after acute myocardial infarction(MI). Previous studies have also suggested that LV diastolic function may contribute with prognostic information. The present study assessed whether this assumption applies to a large population of patients with acute MI who underwent thrombolyt ic therapy.520 out of 608 patients participating in the ATTenuation by Adenosine of Cardiac Complications (ATTACC) study, with an ST-elevation acute MI underwe nt two-dimensional and Doppler echocardiographic examination at 4 (range 2-10) days after admission. During the follow-up period of 31 (S.D.±11) months, car diovascular death occurred in 57 (11%) patients, nonfatal acute MI occurred in 77 (15%), and 124 (24%) patients suffered a combined cardiovascular end-point (either nonfatal acute MI or cardiovascular death). Univariate regression analy sis showed that all indices of LV systolic function predicted cardiovascular dea th and combined cardiovascular end-points. Regarding LV diastolic function only a restrictive filling pattern predicted cardiovascular death. In a multistep mu ltivariate regression analysis in which the variables were introduced in a hiera rchic order age, history of systemic hypertension, wall motion score index (WMSi ), and history of previous MI and diabetes mellitus were independent predictors of cardiovascular death. A history of systemic hypertension or congestive heart failure were independent predictors of nonfatal acute MI, while a history of sys temic hypertension, wall motion score index and diabetes mellitus independently predicted combined cardiovascular end-points.The results of this study confirme d that clinical risk indicators and LV systolic function were the most important independent predictors of cardiovascular death and combined cardiovascular end -points. LV diastolic function assessed by Doppler-echocar-diography did not provide additional prognostic information.展开更多
文摘We studied 536 patients with acute myocardial infarction and echocardiographic assessment of left ventricular systolic and diastolic function and measurement of right ventricular systolic pressure. On multivariable analysis, the grade of diastolic function, mitral regurgitation severity, age, and wall motion score index were independent predictors of right ventricular systolic pressure, and an increase in right ventricular systolic pressure was independently predictive of mortality(hazard ratio 1.22 per 10 mm Hg, p< 0.0001), after adjustment for conventional risk factors and left ventricular function.
文摘In addition to clinical risk markers, indices of left ventricular(LV) systolic function are valuable prognostic markers after acute myocardial infarction(MI). Previous studies have also suggested that LV diastolic function may contribute with prognostic information. The present study assessed whether this assumption applies to a large population of patients with acute MI who underwent thrombolyt ic therapy.520 out of 608 patients participating in the ATTenuation by Adenosine of Cardiac Complications (ATTACC) study, with an ST-elevation acute MI underwe nt two-dimensional and Doppler echocardiographic examination at 4 (range 2-10) days after admission. During the follow-up period of 31 (S.D.±11) months, car diovascular death occurred in 57 (11%) patients, nonfatal acute MI occurred in 77 (15%), and 124 (24%) patients suffered a combined cardiovascular end-point (either nonfatal acute MI or cardiovascular death). Univariate regression analy sis showed that all indices of LV systolic function predicted cardiovascular dea th and combined cardiovascular end-points. Regarding LV diastolic function only a restrictive filling pattern predicted cardiovascular death. In a multistep mu ltivariate regression analysis in which the variables were introduced in a hiera rchic order age, history of systemic hypertension, wall motion score index (WMSi ), and history of previous MI and diabetes mellitus were independent predictors of cardiovascular death. A history of systemic hypertension or congestive heart failure were independent predictors of nonfatal acute MI, while a history of sys temic hypertension, wall motion score index and diabetes mellitus independently predicted combined cardiovascular end-points.The results of this study confirme d that clinical risk indicators and LV systolic function were the most important independent predictors of cardiovascular death and combined cardiovascular end -points. LV diastolic function assessed by Doppler-echocar-diography did not provide additional prognostic information.
