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The early diastolic myocardial velocity: A marker of increased risk in patients with coronary heart disease
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.ORCID iD: 0000-0002-5156-2535
KTH, School of Technology and Health (STH), Medical Engineering. Karolinska Institute, Sweden.
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
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2014 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 34, no 5, 389-396 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Tissue Doppler imaging (TDI) is a promising echocardiographic modality allowing quantification of myocardial performance. However, the prognostic potential of TDI in patients with acute myocardial infarction (AMI) is not yet investigated. We sought to explore the ability of TDI in identifying patients at risk for new cardiovascular events after AMI. Methods: One hundred and nineteen patients with AMI were recruited prospectively (mean age 61 years; range 32-81 years of age). Patients with diabetes mellitus (DM) were excluded. Echocardiography was performed 3-12 months after AMI. Two-dimensional (2-D) and TDI variables were recorded. The patients were followed during a mean period of 4·6 years (range 1-8 years). The primary end-point was defined as any of the following: death from any cause, non-fatal reinfarction or stroke, unstable angina pectoris, congestive heart failure requiring hospitalization and coronary revascularization procedure. Results: Thirty patients had some form of cardiovascular events during follow-up. Seven patients had cardiovascular death, 13 patients had reinfarction and four patients had a stroke. New angina or unstable angina was recorded in 21 patients. Of these patients, 13 underwent percutaneous coronary angioplasty (PCI) or coronary artery bypass grafting (CABG). The early diastolic myocardial velocity (Em) emerged as the only echocardiographic variable that offered a clear differentiation between patients that presented with new cardiovascular (CV) events as compared to the corresponding group without any CV events at follow-up (P<0·05). In multivariate statistical analysis and after adjustment for age, sex, total cholesterol, body mass index (BMI) and other baseline characteristics, Em remained as independent predictors of CV events (HR, 1·18, 95% CI, 1·02-1·36; P<0·05). However, none of the investigated variables evolved as an independent predictor of cardiovascular morbidity and mortality. Conclusion: Em appears to be a sensitive echocardiographic index in identifying non-diabetic patients with AMI at risk of new cardiovascular events.

Place, publisher, year, edition, pages
2014. Vol. 34, no 5, 389-396 p.
Keyword [en]
Early myocardial diastolic velocity, Myocardial infarction, Tissue velocity imaging
National Category
Medical Image Processing
Identifiers
URN: urn:nbn:se:kth:diva-151043DOI: 10.1111/cpf.12110ISI: 000341238500008Scopus ID: 2-s2.0-84908356117OAI: oai:DiVA.org:kth-151043DiVA: diva2:747064
Note

QC 20140915

Available from: 2014-09-15 Created: 2014-09-15 Last updated: 2017-12-05Bibliographically approved
In thesis
1. The Cardiac State Diagram: A new method for assessing cardiac mechanics
Open this publication in new window or tab >>The Cardiac State Diagram: A new method for assessing cardiac mechanics
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2015. 107 p.
Series
TRITA-STH, 2015:2
Keyword
Cardiac State Diagram, Heart, Hydraulic, Mechanics, DAPP, DeltaV, Hydraulic forces, left ventricular, diastole
National Category
Engineering and Technology
Research subject
Applied Medical Technology
Identifiers
urn:nbn:se:kth:diva-202743 (URN)978-91-7595-477-6 (ISBN)
Public defence
2015-04-27, 3-221, Alfred Nobels Alle10, Huddinge, 15:57 (Swedish)
Opponent
Supervisors
Note

QC 20170306

Available from: 2017-03-06 Created: 2017-03-04 Last updated: 2017-03-06Bibliographically approved

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