Impaired Diastolic Recovery after Acute Myocardial Infarction as a Predictor of Adverse Events
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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 basedon the extent of diastolic recovery assessed by echocardiography: group I (n = 241) showed improving diastolic function andgroup II (n = 222) did not. MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, andthese 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 morefrequent in group II than in group I. Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictorsof 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 predictorof MACE. Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.
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 basedon the extent of diastolic recovery assessed by echocardiography: group I (n = 241) showed improving diastolic function andgroup II (n = 222) did not. MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, andthese 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 morefrequent in group II than in group I. Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictorsof 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 predictorof MACE. Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.
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