A novel Doppler echocardiographic index integrating left and right ventricular function is superior to conventional indices for predicting adverse outcome of acute myocardial infarction

Department of Cardiology and Clinical Research, National Hospital Organization Zentsuji Hospital.
The Journal of Medical Investigation 04/2013; 60(1-2):97-105. DOI: 10.2152/jmi.60.97
Source: PubMed


The ratio of peak diastolic early velocity (E) of left ventricular (LV) inflow to peak diastolic longitudinal velocity (e') of the mitral annulus (E/e') is thought to reflect LV filling pressure, and tricuspid annulus velocity at systole (s'-T) is thought to reflect right ventricular function. However, it has not been reported on significance of the combined use of E/e' and (s'-T) to predict outcome of acute myocardial infarction (AMI). Over 21 months, beginning in January 2007, we enrolled 65 AMI patients who were measured hemodynamic and echocardiographic parameters by Swan-Ganz (SG) catheterization just after reperfusion therapy and echocardiography immediately after reperfusion therapy. Cardiac index (CI) and pulmonary capillary wedge pressure (PCWP) via SG catheter were measured, and routine echocardiographic indices, including E, e', E/e', and (s'-T) were determined. In addition, we defined the functional integrated bi-myocardial tissue Doppler (FIT) index as (s'-T)÷E/e'. The relationships between CI, PCWP, and echocardiographic indices were investigated, including FIT index. Moreover, we investigated whether FIT index could predict adverse cardiac events. FIT index was significantly associated with not only CI but also PCWP. In the Cox proportional hazards model, FIT index<1.0 was a significant predictor for adverse outcome of AMI after adjustment for age, Killip class, history of previous coronary revascularization, location of culprit lesion, and LV ejection fraction. The novel index defined as (s'-T)÷E/e' could be quite useful predictor of prognosis in AMI. J. Med. Invest. 60: 97-105, February, 2013.

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Available from: Masataka Sata, Aug 30, 2015
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    • "It is believed that LV filling pressure, left ventricular disorder is reflected by the ratio of peak diastolic early velocity (E) of LV inflow to peak diastolic longitudinal velocity (e’) of the mitral annulus (E/e′). Previous studies have shown that, E/é is significant predictor of AMI.[32] E/é value would improve scientific value of our paper, however, we have not measured E/é values due to the fact that it was not present in our initial working plan. "
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