Frühzeitiges Erkennen einer linksventrikulären Dysfunktion nach akutem Myokardinfarkt: Verlaufsuntersuchung mit der Dopplerechokardiographie*
| Autor: | C. Spielberg, Völler H, T. Linderer, Köhler T, Klaus Schröder, Rolf Schröder, Dissmann R |
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| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Interventional treatment biology E/A ratio medicine.diagnostic_test business.industry medicine.medical_treatment Area under the curve General Medicine Thrombolysis Doppler echocardiography medicine.disease Heart failure Internal medicine Cardiology medicine biology.protein Creatine kinase Myocardial infarction business |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 119:209-216 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2008-1058681 |
| Popis: | The prognosis of acute myocardial infarction depends on the development of left-ventricular dilatation and chronic heart failure. Serial echocardiography was performed on admission and on days 2, 4 and 6, to discover the temporal course of any early myocardial adaptation. There were 78 patients (20 women, 58 men; mean age 59 [49-69] years) with acute myocardial infarction and systemic thrombolysis, first studied up to 4 hours after onset of symptoms. The patients were divided into two groups according to infarct size as measured by creatine kinase ("area under the curve"--AUC); group 1: CK AUC 12 IU/ml.h. While there was no difference between the two groups on admission and on day 2, filling patterns differed significantly at the end of the first postinfarction week in that maximal early diastolic flow velocity (E) in group 1 was 0.65 m/s, but 0.73 m/s in group 2 (P < 0.05); maximal late diastolic flow velocity (A), group 1: 0.71, group 2: 0.58 m/s (P < 0.01); E/A ratio: 0.89 vs 1.22 (P < 0.001); integrated E/A ratio 1.37 vs 1.77 (P < 0.001), and the atrial component of left-ventricular filling 42 vs 36% (P < 0.001). It is concluded that the serial measurement of left-ventricular filling by Doppler echocardiography in the first post-infarction week can identify patients with impaired left-ventricular function through differences in flow pattern. Drug or interventional treatment can then be started early to prevent further left-ventricular dilatation and in this way improve prognosis. |
| Databáze: | OpenAIRE |
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