Combination study of myocardial perfusion and left ventricular filling provides an excellent prediction of clinical outcomes in patients with reperfused myocardial infarction

Hiroshi Itoh, N. Komura, K. Iwakura, S. Kawano, A. Okamura, K. Fujii

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The no reflow phenomenon and left ventricular (LV) diastolic dysfunction are surrogate markers of poor outcomes in patients with myocardial infarction (MI). We studied the relationship between contrast perfusion defects and restrictive filling patterns for predicting prognosis after MI. Mitral inflow velocity and myocardial contrast perfusion were studied 2 weeks after reperfusion in 226 consecutive patients with acute MI. The cohort was divided into two groups according to the number of perfusion defect segments (PD); large-PD and small-PD. Mitral inflow was classified into two categories according to deceleration time; non-restrictive and restrictive. The patients were divided into 4 groups (small-PD/non-restrictive, n = 124; small-PD/restrictive, n = 29; large-PD/non-restrictive, n = 50; large-PD/restrictive, n = 23). LV end-diastolic volume index was the greatest and cardiac event rate was the highest in large-PD/restrictive, followed by large-PD/ non-restrictive, small-PD/restrictive, and by small- PD/non-restrictive (81 ± 19 vs. 74 ± 17 vs. 66 ± 19 vs. 59 ± 15ml/m2, events: 61 % vs. 16% vs. 14% vs. 8 %). Multivariate analysis revealed the large-PD is the most powerful predictive factor related to cardiac events (odds ratio = 5.5, P = 0.004) followed by the restrictive filing pattern (4.3, P = 0.005). Co-existence of large-PD and restrictive filling is a strong predictor of adverse outcomes in the patients with MI.

Original languageEnglish
Pages (from-to)400-407
Number of pages8
JournalBasic Research in Cardiology
Volume101
Issue number5
DOIs
Publication statusPublished - Sep 2006
Externally publishedYes

Fingerprint

Perfusion
Myocardial Infarction
No-Reflow Phenomenon
Deceleration
Left Ventricular Dysfunction
Stroke Volume
Reperfusion
Multivariate Analysis
Biomarkers
Odds Ratio

Keywords

  • Ccontrast medium
  • Echocardiography
  • Microcirculation
  • Myocardial infarction
  • Relaxation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Combination study of myocardial perfusion and left ventricular filling provides an excellent prediction of clinical outcomes in patients with reperfused myocardial infarction. / Itoh, Hiroshi; Komura, N.; Iwakura, K.; Kawano, S.; Okamura, A.; Fujii, K.

In: Basic Research in Cardiology, Vol. 101, No. 5, 09.2006, p. 400-407.

Research output: Contribution to journalArticle

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