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Chest, Vol 100, 28-33, Copyright © 1991 by American College of Chest Physicians

ARTICLES

Late variation in ventricular function after myocardial infarction

VH Humbert Jr, H Jabi, AJ Burger and RC Touchon
Department of Medicine, Marshall University School of Medicine, Huntington, WV.

To assess the possible role of variables not related to early infarct artery reperfusion in predicting late changes in ventricular function after infarction, paired early (mean 6.6 +/- 3.5 days after admission) and late (12.7 +/- 7.0 months later) cross-sectional echocardiograms from 54 infarction survivors were retrospectively reviewed. Ejection fraction was calculated from digitized biapical echocardiographic views on a graphics tablet. Changes of 0.10 or more in LVEF were correlated with 23 clinical variables. By stepwise regression analysis, Q-wave infarction and low early LVEF independently predicted late improvement in function. Early high LVEF and interval infarction were the only independent predictors of late declines in function. Overall, when patients were indexed by early left ventricular systolic function, a pronounced late "regression to the mean" was noted with initially high values tending to fall and low values to rise (r = -0.44, p less than 0.001). This effect must be accounted for in any acute intervention trial in myocardial infarction. The occurrence of Q-wave infarction does not exclude late improvement in ventricular function.


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F Nijland, O Kamp, P M J Verhorst, W G de Voogt, and C A Visser
Early prediction of improvement in ejection fraction after acute myocardial infarction using low dose dobutamine echocardiography
Heart, December 1, 2002; 88(6): 592 - 596.
[Abstract] [Full Text] [PDF]


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Copyright © 1991 by the American College of Chest Physicians.