Relationship between noninvasive reperfusion criteria and pulsed-wave tissue Doppler parameters in patients with acute myocardial infarction receiving thrombolytic therapy.

Several studies have proven that noninvasive reperfusion criteria (NRC) have prognostic significance in patients receiving thrombolytic therapy (TT) after acute myocardial infarction (acute MI). In this study, we investigated the relationship between NRC and pulsed tissue Doppler (PTD) parameters in patients receiving TT after acute MI, and the role of PTD in the management and follow-up of patients with acute MI. The study group(n= 41)was divided into four subgroups defined as: anterior and posterior MI, with or without NRC. In the first PTD measurements (2-3 days after acute MI), all acute MI patients had significantly smaller peak systolic (S-wave) velocity in all evaluated segments and longer Q-Speak durations (time elapsed from the inscription of the Q-wave on the surface ECG to the peak of the S-wave in PTD) as compared with control patients(n= 22; P < 0.001 for both). Among the diastolic parameters, the E/A ratio was significantly smaller in the study group compared with the control group(P < 0.001). Among the patients who had received TT in the first 2 hours, those patients who had NRC displayed significantly higher peak S-wave values in all evaluated segments than those without NRC(P < 0.05). The second PTD study (4-5 weeks after acute MI), revealed that the difference between the systolic PTD parameters of the noninfarcted regions of the study and control groups disappeared. Infarct-related segments, however, displayed significant improvement only in patients having NRC. There was a significant positive correlation between the mean mitral annular S-wave velocity and left ventricular ejection fraction(r = 0.59, P < 0.001). In conclusion, a significant relationship was observed between the PTD parameters and the NRC, which are known to have prognostic significance.