Impaired Lv Function in Acute Myocardial Infarction (AMI), Assessed Non-Invasively by Doppler Ultrasound

1984 ◽  
Vol 67 (s9) ◽  
pp. 42P-42P ◽  
Author(s):  
N. Mehta ◽  
E.D. Bennett
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Doppler Ultrasound ◽  
Lv Function

scholarly journals Echocardiographic assessment of left ventricular function in patients of acute myocardial infarction

2017 ◽  
Vol 4 (4) ◽  
pp. 926
Author(s):  
Anjali V. Shivpuje ◽  
Shrikant Page
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Wall Motion ◽  
Health Centre ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Lv Function ◽  
Regional Wall ◽  
Wall Motion Abnormalities ◽  
Echocardiographic Assessment

Background:2D Echo can evaluate LV anatomy, function and diagnose post AMI complications in early stages, thus help in management and determining the prognosis. The present study was undertaken to evaluate LV function in patient following AMI and also to find out the incidence of various echocardiographically detectable complications of following AMI.Methods: The present study was conducted on patients visiting our tertiary health centre during study duration. 50 patients were included in the study. Patients with prior history of acute myocardial infarction, pericarditis and early repolarisation syndrome, and primary myocardial disease diagnosed by serum enzyme levels were not included in the study. Patients were classified as per Killip classification and 2D echo study was performed in all patients.Results: Maximum incidence of AMI was found in 51-60 years of age, with male predominance (64%). Anterior wall AMI (58%) was more common. 94% of patients had wall motion abnormalities. Incidence of LV thrombus was found to be 24%. In present study, as the extent and severity of wall motion abnormalities increased, the incidence of LV thrombus also increased. Thus, 2DE study of LV regional wall motion can predict the incidence of LV thrombus.Conclusions: The echocardiographic assessment of LV function in patients of AMI is important as, it detects the regional wall motion abnormality, LVEF and also the complications like LV thrombus, pericardial effusion and LV aneurysm. These observations are of great value in the management of AMI.  

Plasma cardiotrophin-1 following acute myocardial infarction: relationship with left ventricular systolic dysfunction

2001 ◽  
Vol 102 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Suneel TALWAR ◽  
Iain B. SQUIRE ◽  
Russell J. O'BRIEN ◽  
Paul F. DOWNIE ◽  
Joan E. DAVIES ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Clinic Visit ◽  
Left Ventricular ◽  
Lv Function ◽  
Ventricular Remodelling

The glycoprotein 130 (gp130) signalling pathway is important in the development of heart failure. Cardiotrophin-1 (CT-1), a cytokine acting via the gp130 pathway, is involved in the process of ventricular remodelling following acute myocardial infarction (AMI) in animals. The aims of the present study were to examine the profile of plasma CT-1 following AMI in humans, and its relationship with echocardiographic parameters of left ventricular (LV) systolic function. Serial measurements of plasma CT-1 levels were made in 60 patients at 14-48h, 49-72h, 73-120h and 121-192h following AMI and at a later clinic visit. LV function was assessed using a LV wall motion index (WMI) score on admission (WMI-1) and at the clinic visit (WMI-2). Compared with values in control subjects (29.5±3.6fmol/ml), the plasma CT-1 concentration was elevated in AMI patients at 14-48h (108.1±15.1fmol/ml), 49-72h (105.2±19.7fmol/ml), 73-120h (91.2±14.9fmol/ml) and 121-192h (118.8±22.6fmol/ml), and at the clinic visit (174.9±30.9 fmol/ml) (P < 0.0001). Levels were higher following anterior compared with inferior AMI. For patients with anterior AMI, CT-1 levels were higher at the clinic visit than at earlier times. WMI-1 correlated with CT-1 at all times prior to hospital discharge (P < 0.05). On best subsets analysis, the strongest correlate with WMI-1 was CT-1 level at 49-72h (R2 = 20%, P < 0.05). In conclusion, plasma levels of CT-1 are elevated soon after AMI in humans and rise further in the subsequent weeks in patients after anterior infarction. CT-1 measured soon after AMI is indicative of LV dysfunction, and this cytokine may have a role in the development of ventricular remodelling and heart failure after AMI.

Measurement of Aoptic Blood Velocity in Acute Myocardial Infarction by Doppler Ultrasound

1984 ◽  
Vol 67 (s9) ◽  
pp. 4P-4P
Author(s):  
D. Robson ◽  
J. Flaxman ◽  
A. Mayhfw ◽  
S. Powell ◽  
R. Malik
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Doppler Ultrasound ◽  
Blood Velocity

scholarly journals Cardiogenic shock without hypotension in acute myocardial infarction

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
R Caldeira Da Rocha ◽  
B Picarra ◽  
R Fernandes ◽  
F Dias Claudio ◽  
M Carrington ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Left Ventricular ◽  
Hospital Death ◽  
Lv Function ◽  
Vessel Occlusion ◽  
Funding Sources ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiogenic Shock(CS)complicates 10%of Acute Myocardial Infarction(AMI), being the main cause for intra-hospital death in these patients.Although early revascularization has contributed to increase survival,mortality still presents high, being 40-50%.CS usually presents with inadequate cardiac output and persistent hypotension.However,after large AMI,peripheral hypoperfusion can occur with sustained or borderline systolic blood pressure(SBP). Purpose Characterize patients(pts)with CS after AMI in the absence of hypotension(defined as SBP &lt; 90mmHg),and assess impact in mortality. Methods We evaluated 528pts presenting with CS in context of AMI.We considered 2groups:Group 1-Pts who had SBP ≥90mmHg,without any inotropic drug or assist device and 2-Pts with SBP &lt; 90mmHg.We registered age,gender,co-morbidities,presentation,coronary anatomy and treatment strategies.We evaluated in-hospital mortality and complications:re-infarction,mechanical complications,high-grade atrioventricular block(AVB),sustained ventricular tachycardia,atrial fibrillation,resuscitated cardiac arrest and stroke. Results AMI presenting as Cardiogenic Shock without hypotension(CSWH)was found in 51%of pts(n = 272),of whom 69%were male.They were younger(between age of 45-64years old in 34%of cases vs 25%,p = 0.040)and had higher body mass index (27.3 ± 4.5vs 26 ± 4.1,p = 0.001).Hypertension was a similarly distributed comorbidity.In group 1,pts were previously more frequently under beta blocker medication (25.2%vs 17.7%,p = 0.047).In this group,mean left ventricular (LV)ejection fraction was 39 ± 13%,a quarter having severely depressed LV function(&lt;30%).Although STEMI was the most common presentation in both sets(73.5% vs 87.1%,p &lt; 0.001),NSTEMI was more prevalent in CSWH(23.9%vs12.1%,p &lt; 0.001).Those pts presented more,at admission,with dyspnea(14.9%vs5.5%,p &lt; 0.001)and in sinus rhythm(81.9%vs69%,p &lt; 0.001).In this group,ICU admission was less frequent(19.4%vs27.2%,p = 0.036),and only about half of pts were medicated with inotropic drugs(vs 78.1%,p &lt; 0.001).However,difference in intra-aortic balloon use wasn’t found.CSWH presented with multivessel disease in 63.8%of pts,being LAD more frequently the culprit vessel(42.4% vs 30.7%,p = 0.030),but fewer left main artery(LM)(4.2%vs14.0%,p = 0.003).Group 1 had fewer prevalence of vessel occlusion,which was particularly true for LM(3.8%vs11.5%,p = 0.015) and circumflex(12.4%vs20.7%,p = 0.047),and were less often submitted to revascularization.Group 1 had fewer AVB(9.8%vs22.4%,p &lt; 0.001).Rates of other complications were similar.In-hospital mortality was higher in classic CS(33.1% vs 43.8%, p= 0.012). Conclusion Cardiogenic Shock without hypotension was found in about half of pts with CS due to AMI.A majority of these were younger and globally had a less severe event and complications.Even though CSWH was associated with one third of in-hospital mortality,it was lower than in pts with hypotension.

scholarly journals Single vs. Double Intracoronary Injection of Mesenchymal Stromal Cell after Acute Myocardial Infarction: The Study Protocol from a Randomized Clinical Trial. BOOSTER-TAHA7 trial

2021 ◽  
Author(s):  
Armin Attar ◽  
Fatemeh Nouri ◽  
Arash Yazdanshenas ◽  
Kamran Hessami ◽  
Massoud Vosough ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mesenchymal Stromal Cell ◽  
Stromal Cell ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Ventricular Ejection Fraction ◽  
Paracrine Effect ◽  
Intracoronary Infusion

Abstract BackgroundMeta-analysis from previous studies have shown that treatment with Mesenchymal stromal cell (MCSs) may increase the left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI) by 3.84% and the effect is greater in those who are not aged and have developed a reduced LVEF. However, it seems that MSC transplantation does its effect through an indirect paracrine effect and direct differentiation to the cardiomyocytes does not occur. Therefore, it can be hypothesized that this paracrine effect would be augmented if repeated doses of MSC are transplanted. This study is conducted to compare single vs. double injection of MSCs.MethodsThis is a single-blind, randomized, multicenter trial aiming to determine whether intracoronary infusion of double doses of umbilical cord-derived Wharton’s jelly MSCs (WJ-MSCs) improves LVEF more after AMI compared to single administration. The study will enroll 60 AMI 3 to 7 days after AMI. The patients should be under 65 years old and have a severe impairment in LV function (LVEF < 40%). They will be randomized to three arms receiving single or double doses of intracoronary infusion of WJ-MSCs or placebo. Primary endpoint of this study is assessment of improvement in LVEF at 6-month post intervention as compared to the baseline. DiscussionThis investigation will help to determine whether infusion of booster (second) dose of intracoronary WJ-MSCs in patients with AMI will contribute to increasing its effect on the improvement of myocardial function.Trial registrationIRCT20201116049408N1. (www.IRCT.ir)

scholarly journals Predictors of Ischemic Cardiomyopathy in Patients with Acute Myocardial Infarction who Underwent Percutaneous Coronary Intervention

2020 ◽  
Vol 95 (3) ◽  
pp. 188-200
Author(s):  
Hye Sook Kim ◽  
Myung Ho Jeong ◽  
Hyun Ju Yoon ◽  
Yongcheol Kim ◽  
Seok-Joon Sohn ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ischemic Cardiomyopathy ◽  
Multivariate Logistic Regression Analysis ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Lv Function ◽  
Mitral Inflow ◽  
Diastolic Velocity ◽  
Mitral Inflow Velocity

Background/Aims: Many patients with acute myocardial infarction (AMI) suffer from heart failure due to progressive ischemic left ventricular (LV) remodeling. This study investigated the predictors of ischemic cardiomyopathy (ICMP) in patients with AMI who underwent successful percutaneous intervention.Methods: A total of 547 patients with AMI were divided into two groups: ICMP (n = 66, 67.1 ± 11.9 years, 78.8% males) and non-ICMP (n = 481, 62.5 ± 12.2 years, 70.1% males).Results: On echocardiography, the LVEF was significantly decreased (41.7 ± 10.5 vs. 55.4 ± 10.3%, <i>p</i> < 0.001) but the LV end-diastolic (54.1 ± 7.2 vs. 49.3 ± 5.3 mm, <i>p</i> < 0.001) and systolic (42.1 ± 8.0 vs. 33.5 ± 6.0 mm, <i>p</i> < 0.001) dimensions significantly increased in the ICMP group compared with the non-ICMP group. According to multivariate logistic regression analysis, LVEF < 50% (odds ratio [OR] 8.722, 95% confidence interval [CI] 2.986–25.478, <i>p</i> < 0.001), LV end-diastolic dimension > 55 mm (OR 4.511, 95% CI 1.561–13.038, <i>p</i> = 0.005), and ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e’) ≥ 15 (OR 3.270, 95% CI 1.168–9.155, <i>p</i> = 0.024) were independent predictors of ICMP development.Conclusions: The present study demonstrates that a larger LV size, lower LV function, and increased E/e’ (≥ 15) were independent predictors of ICMP. Therefore, the development of ICMP should be carefully monitored in AMI patients with these features.

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