کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2935842 | 1576378 | 2007 | 7 صفحه PDF | دانلود رایگان |

PurposeTo assess factors of importance for long term prognosis in patients with acute myocardial infarction (AMI) and heart failure and normal or mildly reduced left ventricular systolic function.Subjects and methodsSeventy-one consecutive AMI-survivors with clinical or radiological signs of heart failure and an echocardiographically determined wall motion score > 1.2 (EF > 35–40%) were followed during 11 years for mortality, heart failure readmissions and new ischemic events.ResultsSeventeen patients died (24%) while the combined endpoint of death or a new ischemic event (MI or hospitalisation for angina pectoris) occurred in 40 (56%) and fatal or non-fatal heart failure in 20 (28%) patients, respectively. A pre-discharge echocardiographic assessment of diastolic function was obtained in 67 patients out of whom 56 (84%) had diastolic dysfunction, most frequently relaxation abnormalities (43%). Wall motion score did not differ between survivors and non-survivors (1.48 ± 0.20 vs. 1.44 ± 0.18; p = 0.46). Adjusting for age, sex and wall motion score N-terminal pro-ANP, prolongation of the isovolumic relaxation time and exercise induced ST-depressions at discharge (global χ2 = 26.2; p < 0.0001) remained as independent mortality predictors while re-admission for heart failure was predicted by wall motion score, N-terminal pro-ANP and previous heart failure (global χ2 = 23.7; p < 0.001). Death or new ischemic events were associated with low Doppler A-wave flow velocity and male sex (global χ2 = 14.0; p < 0.01).ConclusionsEvaluation of diastolic function and a natriuretic peptide adds prognostically important information in AMI-patients with clinical heart failure and normal or mildly reduced left ventricular systolic function. Isovolumic relaxation time is an independent predictor of long term mortality and N-terminal pro-ANP of mortality and heart failure.
Journal: International Journal of Cardiology - Volume 117, Issue 2, 25 April 2007, Pages 184–190