Background: After acute myocardial infarction, a broad range of left ventricular (LV) end-diastolic pressure (LVEDP) is expected because of chamber remodeling. However, intrinsic characteristics of the infarcted tissue (necrosis or viability) may also play a role. We aimed to evaluate whether myocardial viability (Mviab) has an influence on LVEDP.
Methods: One hundred twenty-three consecutive patients with acute myocardial infarction underwent low-dose dobutamine echocardiography (5-10 microg/kg/min) to assess Mviab. Mviab was quantitatively evaluated by the variation of Delta wall motion score index. Patients underwent left heart catheterization with recording of LVEDP and a complete echocardiographic examination with measurement of LV volumes, ejection fraction, and mass.
Results: The overall population (81% male; mean age 58 +/- 10 years) was divided into 2 groups according to the presence (group 1; 66 patients) or absence (group 2; 57 patients) of Mviab. LVEDP was higher in patients without Mviab (16 +/- 8 vs 20 +/- 7 mm Hg; P =.02). The multivariate analysis showed that Delta wall motion score index correlated with LVEDP (P =.01) independent of wall motion score index and LV end-systolic volume.
Conclusions: After acute myocardial infarction, LVEDP shows wide variability and is independently associated with Mviab.
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