Korean J Med.  2018 Dec;93(6):538-547. 10.3904/kjm.2018.93.6.538.

Impacts of Diastolic Function on Clinical Outcomes in Young Patients with Acute Myocardial Infarction

• Cho EY
• Jeong MH
• Yoon HJ
• Kim YC
• Sohn SJ
• Kim MC
• Sim DS
• Hong YJ
• Kim JH
• Ahn Y
• Cho JY
• Kim KH
• Park JC

• KMID: 2438045
• DOI: http://doi.org/10.3904/kjm.2018.93.6.538

Abstract

BACKGROUND/AIMS
The impact of left ventricular (LV) diastolic function and filling pressure on clinical outcomes in young patients with acute myocardial infarction (AMI) has been poorly studied. Therefore, the aim of this study was to investigate the impact of LV diastolic function and LV filling pressure on major adverse cardiac events (MACEs) in young patients with AMI.
METHODS
A total of 200 young patients (males < 45 year, females < 55 year) with AMI were divided into two groups according to the diastolic function; normal (n = 46, 39.5 ± 5.3 years) versus abnormal (n = 154, 43.5 ± 5.1 years).
RESULTS
Despite regional wall motion abnormalities, normal LV diastolic function was not uncommon in young AMI patients (23.0%). During the 40 months of clinical follow-up, MACEs developed in 26 patients (13.0%); 14 re-percutaneous coronary intervention (7.0%), 8 recurrent MI (4.0%), and 4 deaths (2.0%). MACEs did not differ between the normal and abnormal diastolic function group (13.6% vs. 10.9%, p = 0.810), but MACEs were significantly higher in the high LV filling pressure group than the normal LV filling pressure group (36.8% vs. 10.5%, p < 0.001). On multivariate analysis, high LV filling pressure was an independent predictor of MACEs (hazard ratio 3.022, 95% confidence interval 1.200-7.612, p = 0.019).
CONCLUSIONS
This study suggested that measurement of the LV filling pressure (E/e' ratio) would be useful in the risk stratification of young patients with AMI. However, it would be necessary to monitor this category of patient more carefully.

Keyword

Diastole; Myocardial infarction; Mortality

MeSH Terms

Diastole
Female
Follow-Up Studies
Humans
Mortality
Multivariate Analysis
Myocardial Infarction*