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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 - J Cardiovasc Ultrasound (2015)

Bottom Line: 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.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.Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.

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.

No MeSH data available.


Related in: MedlinePlus

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

Mentions: During the follow-up period (mean 910 ± 750 days), MACE occurred in 124 patients (31 deaths, 12 recurrent MIs, and 81 rehospitalizations due to heart failure) and were significantly more frequent in group II than in group I (76 vs. 48, respectively) (p = 0.001) (Fig. 1). Significantly more deaths occurred in group II than in group I (24 vs. 7, respectively) (p = 0.001), but the number of patients with recurrent MI (4 in group I vs. 8 in group II) as well as the number requiring rehospitalization (38 in group I vs. 43 in group II) did not differ significantly between groups I and IIII, 38. Cumulative survival and MACE-free survival rates were significantly lower in group II than in group I on Kaplan-Meier analysis (Fig. 2).


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 - J Cardiovasc Ultrasound (2015)

Comparison of deaths and major adverse cardiac events (MACE) between group I (improving) and group II (non-improving).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4595702&req=5

Figure 1: Comparison of deaths and major adverse cardiac events (MACE) between group I (improving) and group II (non-improving).
Mentions: During the follow-up period (mean 910 ± 750 days), MACE occurred in 124 patients (31 deaths, 12 recurrent MIs, and 81 rehospitalizations due to heart failure) and were significantly more frequent in group II than in group I (76 vs. 48, respectively) (p = 0.001) (Fig. 1). Significantly more deaths occurred in group II than in group I (24 vs. 7, respectively) (p = 0.001), but the number of patients with recurrent MI (4 in group I vs. 8 in group II) as well as the number requiring rehospitalization (38 in group I vs. 43 in group II) did not differ significantly between groups I and IIII, 38. Cumulative survival and MACE-free survival rates were significantly lower in group II than in group I on Kaplan-Meier analysis (Fig. 2).

Bottom Line: 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.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.Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.

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.

No MeSH data available.


Related in: MedlinePlus