Usefulness of predischarge echocardiographic criteria in predicting complications following acute myocardial infarction

Andre Keren, Shmuel Gottlieb, Yuri Arbov, Alex Gavish, Dan Tzivoni, Shlomo Stern

Research output: Contribution to journalArticlepeer-review

Abstract

In 103 patients who recovered from an acute myocardial infarction (AMI) we evaluated the usefulness of predischarge clinical, routine laboratory and M-mode echocardiographic (echo) criteria in predicting cardiac complications during a period of 12-41 months (25.0 ± 10.7 months) follow-up. The echo parameters evaluated were: Left ventricular diastolic diameter, left ventricular percent fractional shortening and the mitral valve E point septal separation. The combination of these three echo criteria was defined as an echo-index, which was considered abnormal if at least two of the three single parameters were pathological. Congestive heart failure occurred in 35 (34%) patients, with significantly higher prevalence among those older than 65 years, with previous AMI and with predischarge findings of heart failure. However, the sensitivity of these clinical parameters was unsatisfactory (34-69%). The sensitivity, specificity and positive predictive value of the echo-index for future heart failure were 89, 88 and 80%, respectively. Chest pain prior to hospital discharge was the only criteria predicting high risk of reinfarction (p = 0.001). The risk of cardiac death was related to age older than 65 years (p = 0.03) and an abnormal echo-index (p = 0.01). The overall mortality rate was 13%, but only 6% among those with normal and 26% among those with pathologic echo-index. In conclusion, in patients who recovered from an AMI, a simple and easily measured echo-index was superior to most clinical and routine laboratory criteria in predicting future heart failure and cardiac death.

Original languageEnglish
Pages (from-to)139-146
Number of pages8
JournalCardiology
Volume73
Issue number3
DOIs
StatePublished - 1986
Externally publishedYes

Keywords

  • Acute myocardial infarction
  • Echocardiography
  • Ischemic heart disease

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