| Abstrakt: |
Background: Myocardial infarction (MI) leads to varying levels of left ventricular (LV) function, with different hemodynamic responses. Some patients with small infarcts and increased sympathetic activity may have normal or even supra-normal LV function. As the infarct size increases, LV function tends to decline and shift to the right. Assessing LV function by combining left ventricular end-diastolic pressure (LVEDP) and cardiac output can be valuable. Mean pulmonary capillary wedge pressure provides a reliable estimate of LVEDP, particularly when pulmonary vascular resistance is normal, making pulmonary artery diastolic pressure equivalent to the pulmonary capillary wedge pressure. Objective: To estimate LVEDP in AMI patients, regardless of their LV function status, for prognostic and treatment guidance purposes. Methods: This two-year hospital-based study involved 40 AMI patients admitted to the ICCU of BTGH. Patients with mitral or aortic valve diseases or arrhythmias were excluded. Detailed patient information was recorded using a standardized form, and any complications were documented. Results: In this study, AMI was most common in individuals aged over 60, with a higher prevalence in males than females. Key risk factors included smoking, male gender, hypertension, diabetes mellitus, and a family history of coronary artery disease. The most common symptom of AMI was chest pain, often accompanied by sweating. Other symptoms included vomiting, dyspnea, and syncope. LV Function: Among the patients, 37.5% exhibited LV diastolic dysfunction, 17.5% had systolic dysfunction, 12.5% had combined dysfunction, and 32.5% had normal LV function. LVEDP in 1st and 2nd study: Many patients showed moderate elevation of LVEDP, with values of 32 and 24 in the first and second studies, respectively. Severe elevation was observed in 3 and 6 patients in the first and second studies, respectively, while mild elevation was noted in 4 and 6 patients in the first and second studies, respectively. Conclusion: In patients with AMI in sinus rhythm and LV dysfunction, LVEDP can be reliably assessed from mitral flow velocity curves. Changes in filling pressures may help predict prognosis. [ABSTRACT FROM AUTHOR] |
