Early predictors of left ventricular function improvement late after myocardial infarction
Background/Aim. Prognosis after acute myocardial infarction (AIM) depends on the extent of irreversibly damaged myocardium and viable tissue due to stunning or hibernation. The aim of the study was to assess the prognostic significance of early echocardiographic parameters of myocardial viability in...
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| Format: | Article |
| Language: | English |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2008-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500801009M.pdf |
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| author | Mladenović Zorica Angelkov-Ristić Anđelka Kalimanovska-Oštrić Dimitra Mijailović Zdravko Gligić Branko Obradović Slobodan Tavčiovski Dragan Jovelić Aleksandra |
| author_facet | Mladenović Zorica Angelkov-Ristić Anđelka Kalimanovska-Oštrić Dimitra Mijailović Zdravko Gligić Branko Obradović Slobodan Tavčiovski Dragan Jovelić Aleksandra |
| author_sort | Mladenović Zorica |
| collection | DOAJ |
| description | Background/Aim. Prognosis after acute myocardial infarction (AIM) depends on the extent of irreversibly damaged myocardium and viable tissue due to stunning or hibernation. The aim of the study was to assess the prognostic significance of early echocardiographic parameters of myocardial viability in prediction of late recovery of regional and global ventricular function. Methods. The study prospectively included 40 patients after the first, uncomplicated univessel AIM treated with percutaneous coronary intervention (PCI). Low-dose dobutamine echocardiography (LDDE) was preformed 7-10 days after AIM and follow-up resting echocardiography from 7 to 12 months later. Results. The sensitivity and specificity for the prediction of post revascularisation regional, dyssynergy improvement were 61.29% and 94.59% respectively. The positive and negative predicative values were 90.48% and 74.47% respectively. The number of viable segments (p = 0.01) and extent of contractile reserve (p = 0.01) were univariate, independent predictors of improvement in ejection fraction (EF). From the multivariate stepwise regression analysis contractile reserve was selected as most powerful predictor of late recovery of left ventricular contractile function (p = 0.007). Receiving-operator characteristic curve (ROC) analysis demonstrated that three or more recovered segments were necessary for an improvement of left ventricular ejection fraction (LVEF) ≥ 5% after the revascularisation, with the highest sensitivity, 100% and specificity 56% (p = 0.01). Conclusion. Low-dose dobutamine echocardiography is a powerful predictor of the regional dyssynergy recovery late after AIM treated with PTCA with implantation stent. Late full functional improvement of the left ventricle is related to the extent of contractile reserve and amount of viable tissue. At least three recovered segments are necessary for a significant recovery of the global left ventricular contractility. |
| format | Article |
| id | doaj-art-e795ee1d89b1467e87b14c14be035e8b |
| institution | OA Journals |
| issn | 0042-8450 |
| language | English |
| publishDate | 2008-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-e795ee1d89b1467e87b14c14be035e8b2025-08-20T02:03:51ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502008-01-0165191410.2298/VSP0801009MEarly predictors of left ventricular function improvement late after myocardial infarctionMladenović ZoricaAngelkov-Ristić AnđelkaKalimanovska-Oštrić DimitraMijailović ZdravkoGligić BrankoObradović SlobodanTavčiovski DraganJovelić AleksandraBackground/Aim. Prognosis after acute myocardial infarction (AIM) depends on the extent of irreversibly damaged myocardium and viable tissue due to stunning or hibernation. The aim of the study was to assess the prognostic significance of early echocardiographic parameters of myocardial viability in prediction of late recovery of regional and global ventricular function. Methods. The study prospectively included 40 patients after the first, uncomplicated univessel AIM treated with percutaneous coronary intervention (PCI). Low-dose dobutamine echocardiography (LDDE) was preformed 7-10 days after AIM and follow-up resting echocardiography from 7 to 12 months later. Results. The sensitivity and specificity for the prediction of post revascularisation regional, dyssynergy improvement were 61.29% and 94.59% respectively. The positive and negative predicative values were 90.48% and 74.47% respectively. The number of viable segments (p = 0.01) and extent of contractile reserve (p = 0.01) were univariate, independent predictors of improvement in ejection fraction (EF). From the multivariate stepwise regression analysis contractile reserve was selected as most powerful predictor of late recovery of left ventricular contractile function (p = 0.007). Receiving-operator characteristic curve (ROC) analysis demonstrated that three or more recovered segments were necessary for an improvement of left ventricular ejection fraction (LVEF) ≥ 5% after the revascularisation, with the highest sensitivity, 100% and specificity 56% (p = 0.01). Conclusion. Low-dose dobutamine echocardiography is a powerful predictor of the regional dyssynergy recovery late after AIM treated with PTCA with implantation stent. Late full functional improvement of the left ventricle is related to the extent of contractile reserve and amount of viable tissue. At least three recovered segments are necessary for a significant recovery of the global left ventricular contractility.http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500801009M.pdfmyocardial infarctionechocardiogaphystressstroke volumeangioplastytransluminalpercutaneous coronaryprognosis |
| spellingShingle | Mladenović Zorica Angelkov-Ristić Anđelka Kalimanovska-Oštrić Dimitra Mijailović Zdravko Gligić Branko Obradović Slobodan Tavčiovski Dragan Jovelić Aleksandra Early predictors of left ventricular function improvement late after myocardial infarction Vojnosanitetski Pregled myocardial infarction echocardiogaphy stress stroke volume angioplasty transluminal percutaneous coronary prognosis |
| title | Early predictors of left ventricular function improvement late after myocardial infarction |
| title_full | Early predictors of left ventricular function improvement late after myocardial infarction |
| title_fullStr | Early predictors of left ventricular function improvement late after myocardial infarction |
| title_full_unstemmed | Early predictors of left ventricular function improvement late after myocardial infarction |
| title_short | Early predictors of left ventricular function improvement late after myocardial infarction |
| title_sort | early predictors of left ventricular function improvement late after myocardial infarction |
| topic | myocardial infarction echocardiogaphy stress stroke volume angioplasty transluminal percutaneous coronary prognosis |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500801009M.pdf |
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