J Cardiovasc Ultrasound.  2015 Sep;23(3):150-157. 10.4250/jcu.2015.23.3.150.

Impaired Diastolic Recovery after Acute Myocardial Infarction as a Predictor of Adverse Events

• Yoon HJ
• Kim KH
• Kim JY
• Cho JY
• Yoon NS
• Park HW
• Hong YJ
• Kim JH
• Ahn Y
• Jeong MH
• Cho JG
• Park JC

• KMID: 2068725
• DOI: http://doi.org/10.4250/jcu.2015.23.3.150

Abstract

BACKGROUND
To investigate the impact of left ventricular (LV) diastolic functional recovery on major adverse cardiac events (MACE) 6 months after acute myocardial infarction (AMI) in patients with preserved LV systolic function.
METHODS
A total 463 patients with preserved LV systolic function at 6 months after an AMI were divided into two groups based on the extent of diastolic recovery assessed by echocardiography: group I (n = 241) showed improving diastolic function and group II (n = 222) did not. MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, and these events were compared with the patients' characteristics at baseline.
RESULTS
Compared with group I, the patients in group II were older and had a higher prevalence of hypertension and diabetes. Blood levels of hemoglobin and triglyceride were lower in group II, whereas the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and of high-sensitivity C-reactive protein were higher in this group than in group I. MACE were significantly more frequent in group II than in group I. Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictors of MACE.
CONCLUSION
Despite improvement in LV systolic function, LV diastolic function had not improved in 222 patients (47.9%) by the 6-month follow-up after the index AMI, and impaired diastolic functional recovery was found to be an independent predictor of MACE. Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.

Keyword

Myocardial infarction; Diastolic function; Prognosis

MeSH Terms

C-Reactive Protein
Echocardiography
Follow-Up Studies
Heart Failure
Humans
Hypertension
Myocardial Infarction*
Prevalence
Prognosis
Triglycerides
C-Reactive Protein

Figure

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  Fig. 1 Comparison of deaths and major adverse cardiac events (MACE) between group I (improving) and group II (non-improving).

• 

  Fig. 2 Kaplan-Meier curve analyses of cumulative survival (A) and of major adverse cardiac events (MACE) (B) in group I (improving) and group II (non-improving).

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